J 



A TREATISE 

ON 

THE PLAGUE, 

DESIGNED TO PROVE IT 
From Facts, collected during the Author's residence in Malta, 

WHEN VISITED BY THAT MALADY IN 1813. 
WITH 

OBSERVATIONS ON ITS PREVENTION, 

CHARACTER AND TREATMENT; 

TO WHICH IS ANNEXED 

CONTAINING MINUTES OF THE AUTHOR'S EVIDENCE, GIVEN BEFORE THE 
CONTAGION COMMITTEE OF THE HOUSE OF COMMONS, 

ACCOMPANIED BY THEIR 

REPORT. 

BY 

SIR ARTHUR BROOKE FAULKNER, M. D. 

Felliw of the Royal College of Physicians ; late Physician to His Majesty's 
Forces, and Physician in Ordinary to His Royal Highness 
The Duke of. Sussex. 



Uontrott : 

PRINTED FOR LONGMAN, HURST, REES, ORME, AND BROWN, 

PATERNOSTER-ROW. 

By S. Y. Griffith, Chronicle Office, Portland-Passage, Cheltenham. 



1820. 



f > 1 ^ 



EPISTLE DEDICATORY 

TO THE 

Royal College of Physicians, 

OF LONDON. 



Gentlemen, 

It is some time since I 
first conceived the purpose of 
submitting the results of my 
experience in the Plague to the 
public eye ; but various duties 
and occupations connected with 

a 



VI EPISTLE DEDICATORY. 

my profession, and little com- 
porting with that frame of mind 
which is suited to writing on so 
difficult a subject, have hitherto 
prevented my undertaking the 
task. Finding the same hin- 
drances daily to accumulate, I 
should probably for ever dismiss 
the design from my thoughts, 
especially as the Plague has of 
late years engrossed the atten- 
tion of so many respectable 
writers : — but the following rea- 
sons impose an obligation to 
bring this Volume before the 
Public, which I feel no longer 
at liberty to set aside; namely, 
the justice I owe to the question, 



EPISTLE DEDICATORY. 



and to myself, by rendering my 
evidence, delivered before the 
Committee of the House of 
Commons, more complete ; and 
a desire more effectually to meet 
the wishes of your College, who 
have done me the honor to re- 
quest a communication on this 
subject, for a place in their 
transactions. 

To whom could I have 
so fitly dedicated this Treatise 
as to your Society, in which I 
have had the privilege of fellow- 
ship for above fourteen years? 
Even if the station which the 
Royal College of Physicians 
occupies, at the head of the 



EPISTLE DEDICATORY, 



Medical Profession in this 
Country, did not at once point 
it out as the proper authority 
to which these pages ought 
to be inscribed, the flattering 
reception of the Paper which I 
presented on the subject last 
year, claims this mark of my 
respect as a debt of gratitude. 

Whether the Plague be a 
contagious disease or otherwise, 
is a question involving not 
only the most important conse- 
quences to mankind at large, 
but, so far as it is interwoven 
with the commercial welfare of 
Nations, is to ours one of deep 
and peculiar interest ; and this 



EPISTLE DEDICATORY. . IX 



interest is not a little heightened 
by the late reference of the sub- 
ject to the Legislature, 

The arguments contained in 
my communication to your Col- 
lege, you were pleased to regard 
as conclusive, in demonstrating 
the contagious character of the 
malady ; and I had the pleasure 
of finding that the Report pre- 
sented to the Secretary of State 
was in strict coincidence with my 
own opinions. This Report was, 
moreover, not less a precise anti- 
cipation of that given by the 
Contagion-Committee of the 
House of Commons, nearly a 
year afterwards. It must, there- 



A i EPISTLE DEDICATORY. 

fore, be held satisfactory, that 
the same conclusions should 
have been arrived at, by trains of 
investigation, thus separate and 
independent of each other. 

So far as the fate of the 
question was liable to affect the 
commercial interests of the 
Country, whilst so many at- 
tempts were making to throw 
discredit upon the laws of Qua- 
rantine, Parliament, no doubt, 
consulted a wise policy, in de- 
termining to invest its decision 
with all the authority of legis- 
lative enactment ; as this would 
probably put an end to discon- 
tent, and all differences of sen- 



EPISTLE DEDICATORY. 



xi 



timent in the mercantile world* 
respecting the ^alue of those 
laws, much more effectually 
than any mere professional opi- 
nions could be expected to do. 

The Report of the Com- 
mittee having determined the 
Plague to be, in the strictest 
sense of the term, contagious, 
I have deemed it necessary* 
in consideration of the weight 
attached to my evidence, to 
lay before you a more ex- 
tended and connected statement 
of facts, upon which my con- 
clusions were founded, than the 
circumscribed course of my ex- 
amination before the Committee 



Xll EPISTLE DEDICATORY. 

would allow me to enter into, 
I have, besides, endeavoured 
to illustrate more copiously, 
some of the leading points re- 
lative to which I was interro- 
gated, that they may appear 
with the perspicuity in which 
they present themselves to my 
own mind- For it will be al- 
lowed, that the evidence of a 
person unaccustomed to public 
speaking, and on a subject 
where so much unembarrassed 
self-possession was necessary, 
to guard against the least ap- 
pearance of inconsistency or 
mis-statement, was little likely 
to do justice to the information 



EPISTLE DEDICATORY. 

he could afford, or to convey his 
opinions in all the force of which 
they are susceptible. 

As, in the prosecution of 
my design, of demonstrating the 
Plague to be contagious, the 
most scrupulous caution is ne- 
cessary in reference to facts, I 
have accordingly abstained from 
adducing any, (so far as I am 
conscious,) but such as may be 
relied upon with perfect confi- 
dence ; for, if not altogether too 
notorious to need support, their 
authenticity may be substanti- 
ated by documents the most sa- 
tisfactory. And when I am led to 
the citation of any facts of more 

b 



XIV EPISTLE DEDICATORY. 



than ordinary importance, I have 
been careful that they should be 
produced, accompanied by their 
proper testimonies, when such 
production is of importance ; so 
that, should the reasoning ap- 
pear conclusive, it may be trust- 
ed as resting upon a solid found- 
ation- 

I have already noticed the 
motives which have swayed me 
to venture the publication of this 
Work, though under circum- 
stances very disadvantageous to 
the undertaking; and I would 
trust, that these circumstances 
mav not be under-rated in mv 
claims to indulgence for such 



EPISTLE DEDICATORY. 



XV 



imperfections, as more leisure, 
and a mind more disengaged 
might have enabled me to detect, 
and to rectify. For the fidelity 
of those statements, which re- 
late to things that came under 
my personal observation, I hold 
myself responsible ; and should 
my deductions from them be 
erroneous, I cannot but ac- 
knowledge that they are the 
offspring of mature reflection. 
Keeping the laws of induction, 
as far as possible in view, I 
am, in no instance, conscious 
of having ventured to draw any 
inferences, which my experience 
did not appear to me to war- 



XVi EPISTLE DEDICATORY. 

rant, during my engagement in 
the treatment of the disorder; 
and, whatever opinions resulted 
from that experience, I have as 
carefully endeavoured to correct, 
and to fix, by re-consideration, 
with a mind unbiassed by any 
predilection for theories or for 
authorities. There is, therefore, 
one favor, which, in justice to 
myself, I may be permitted to 
request — that before the reader 
makes his mind up to pronounce 
judgment upon the merits or de- 
merits of this performance, he 
shall be able to declare that he 
came to the subject, as I have 
done myself, without prejudice, 



EPISTLE DEDICATORY. XVU 

or leaning for one side of the 
question or the other. 

It may be seen, by refer- 
ring to a communication which 
I transmitted to the Edinburgh 
Medical and Surgical Journal, 
during my service in the late 
Plague in Malta, published 
in April, 1814, and which was 
the hasty produce of the few mo- 
ments I could snatch from my 
anxious duties, that, unhappily, 
every endeavour on the part of 
the Medical Authorities, em- 
ployed upon that occasion, to ar- 
rive at any clearer notions of the 
pathology of the Plague, or its 
mode of treatment, had alike 



XV11I EPISTLE DEDICATORY. 

failed. To this communication 
I would the more especially beg 
your attention, as a document, 
the fidelity of which is in some 
measure guaranteed, in conse- 
quence of having been written 
whilst the transactions were yet 
pending, and because the facts 
therein stated, have remained 
for the space of five years un- 
contradicted, though open to the 
comments of every person en- 
gaged with me on that service. 
Yet, although our hopes of ac- 
quiring more rational and sci- 
entific views of this mysterious 
disease, were so miserably dis- 
appointed, I would still per- 



EPISTLE DEDICATORY. Xix 



suade myself, that our opportu- 
nities have not been unproduc- 
tive of some useful information, 
in regard, more especially, to the 
means by which attendants on 
the sick, may escape infection 
during the exercise of their ha- 
zardous duties. Until a Phy- 
sician can have some assurance 
that he may prosecute his 
clinical investigations in safety, 
there is but little hope that his 
experience should be rendered 
either productive to himself, or 
available to others. And, even 
if a more efficacious practice in 
this disease were for ever denied 
to our short-sighted Art, it is 



EPISTLE DEDICATORY. 



surely something to be in pos- 
session of facts, to disarm the 
disease so far of its terrors, as 
to shew that the consolations of 
sympathy need not be withheld 
from any apprehension of dan- 
ger, in the last moments of 
hopeless suffering. 

It having been stated by 
some who deny the doctrine of 
Contagion, in reference to the 
Plague, that, did the propaga- 
tion of the disorder depend upon 
such a cause, it could not, by 
possibility, have overleaped the 
rigor of the Health-Laws at 
Malta ; I am placed under the 
necessity of citing a series of 



EPISTLE DEDICATOR If, XXI 

public documents, to prove how 
far this statement is borne out ; 
and as the allegation is in direct 
opposition to the tenor of the 
above-mentioned communica- 
tion in the Edinburgh Journal, 
it becomes the more imperative 
on me to dwell at some length 
on this department of the sub- 
ject; though, I confess much 
against my inclination, as it 
may seem to attach blame to the 
then existing administration, * 
and Medical department, of the 
Island. 



* Few of those who were most about the person and were 
deepest in the confidence of the Officer at the head of the 
Malta Government, during my services in the Plague, enter- 

C 



XXII EPISTLE DEDICATORY, 

When I come to discuss 
the means of preventing the dif- 
fusion of the Plague, I hope to 
be able to afford every proof 
which the nature of the case can 
demand, that the measures 
of public health adopted at the 
commencement, and pursued 
for a considerable time after 
the malady had visited Malta, 
so far from being fitted to op- 
pose an effectual barrier to its 



tained a higher respect for his amiable qualities than myself; 
and it is a source of sincere satisfaction to think that the present 
publication, delayed for nearly seven years since the events 
which it records took place, cannot, by the most distorted 
interpretation, be regarded as proceeding from any motive 
personal to himself, or to any one concerned in the affairs of 
that unhappy crisis. 



• • • 

EPISTLE DEDICATORY, XX111 

progress, were, bona fide, quite 
incommensurate to their object. 
If this can be made out, an es- 
sential point will be attained, 
inasmuch as by having the real 
cause of the diffusion of the 
disease brought to view, the 
very failures of the Health De- 
partment, in place of being cal- 
culated to weaken our confi- 
dence in an efficient Code of 
Health Laws, will serve to be- 
stow upon such a Code much 
additional value. 

But the most important, 
as it is the most extensive in its 
bearings, of all the results arising 
from an investigation of the mis- 



XXIV EPISTLE DEDICATORY; 

takes of that period, is what I 
am now about to state, and 
which I have no doubt of being 
able to substantiate by a series of 
decisive facts and concatenated 
evidence; namely, that the 
Plague is produced by a specific 
Contagion, and communicable 
only by contact or close approxi- 
mation with infected persons or 
materials ; and, consequently, 
that by proper precautions it will 
admit of being completely iso- 
lated from passing beyond the 
subjects of its immediate attack. 

It will be observed, that 
the proposals contained in my 
letter to the Board of Health, 



* 



EPISTLE DEDICATORY. XXV 

and transmitted to that Board 
on the first announcement of the 
disease within the walls of Va- 
letta, though not acted upon for 
nearly three months, were al- 
most a verbatim anticipation of 
the measures by which its pro- 
gress was finally arrested. From 
the very dawning of our mis- 
fortunes, I was thoroughly satis- 
fied, that in a judicious system 
of Police Regulations, supported 
by an efficient armed force, re- 
sided the only hope of our deli- 
verance, and that, indeed, with- 
out such an arrangement, all 
other expedients must only tend; 
as the event proved, to augment 



9 

XXY1 EPISTLE DEDICATORY. 



our miseries by occasioning a 
greater delay. On account of 
these proposals, however, I can- 
not claim any originality, being, 
in truth, little more than the re- 
sult of an acquaintance with the 
errors recorded on some similar 
occasions, and particularly in a 
former instance in this very 
Island, but only shaped and 
adapted to the circumstances of 
our perilous situation. 

However incredible it may 
seem, I have actually heard it 
advanced by some apologists for 
the weak system of precautions 
at Malta, that the Government 
was not warranted to enforce 



EPISTLE DEDICATORY. XXVU 

any stricter measures, until all 
doubts regarding the nature of 
the disease were removed ; and 
for this general reason, that as 
the occasions of alarm for the 
presence of the Plague, in a 
spot so much exposed to it as 
this, might be of frequent oc- 
currence, such measures must 
be attended with the greatest 
possible inconvenience, and 
losses incalculable to trade and 
commerce. But, let me ask, 
what is that inconvenience, and 
what are those losses, in compa- 
rison with the expenditure that 
must inevitably be incurred by 
procrastination, if, upon any of 



XXV111 EPISTLE DEDICATORY. 

those occasions of alarm or sus- 
picion, the disease should un- 
fortunately declare itself to be 
pestilential ; not to speak of the 
expenditure in human life which 
every moment must so fright- 
fully accumulate ? I have been 
told that the expenses and losses 
of every kind produced by the 
late Plague amounted to little 
short of a Million sterling, and 
that the number of victims to its 
fury was not less than Six 
Thousand. 

When Malta, in the former 
Plague of 1675, was devoted to 
a like melancholy fate by doubts 
and delay, the Faculty of Rome, 



EPISTLE DEDICATORY. XXIX 

in reply to a letter from the 
Maltese physicians, the purport 
of which was to require inform- 
ation to adjust their differences 
about the identity of the disease, 
and as to the expediency of put- 
ting the people into close quaran- 
tine, make the following remark, 
which, as it is expressive of the 
line that ought to be taken upon 
all similar emergencies, I shall 
produce in the words of the ori- 
ginal : — " Denique licet aliqui 
negent eum morbum pestis con- 
tagiosa nomine insigniendum, 
tamen in casu ancipiti ubi de 
publica salute agitur, tutior pars 

d 



XXX EPISTLE DEDICATORY, 



eligenda etiam cum incommodo 
rerum, ne serpet latius malum." 

Several vessels in both 
harbours of Valetta, having be- 
come infected from time to time 
during the prevalence of the 
contagion, I am sorry it is not in 
my power to speak satisfactorily 
regarding the modes of their 
respective contamination, not 
having had access to such in- 
formation about the shipping, as 
I could venture to use in a dis- 
cussion of this kind. Doubtless, 
a very high degree of evidence 
might have been obtained from 
this source, as the communica- 



EPISTLE DEDICATORY. XXXI 

tion of the crews with each 
other, and with the inhabitants, 
could be so much more easily 
prevented than in most other 
cases of isolation. The towns 
along both sides of the great har- 
bour of Valetta being more or 
less infected, and the harbour 
narrow and navigable to the very 
shores, vessels might have been 
stationed, as it were, in the very 
bosom of the disease, so that, by 
appointing proper guards over a 
certain number immediately on 
their arrival from a healthy Port, 
additional facts of a peculiarly 
conclusive description might 
have been arrived at, to prove 



XXXii EPISTLE DEDICATORY. 

whether the state of the air alone 
could be capable of generating 
Pestilence : for, if this were the 
case, vessels in such a situation 
could not, by possibility, have 
escaped. 

I might, after the exam- 
ple of others, have added much 
to the number of my proofs of 
the contagious character of the 
Plague, by drawing upon stores 
of cases and recitals, both of re- 
mote and recent authority ; but 
it being my intention, that what I 
have to offer on this subject 
should be wholly grounded 
upon the facts at Malta, I shall 
but rarely detain you with any 



• • • 

EPISTLE DEDICATORY. XXX111 



reference to other sources ; con- 
ceiving, if such facts be insuffi- 
cient to sustain my conclusions, 
it would be a very profitless em- 
ployment of time to cast about 
for authorities in order to sup- 
ply the deficiencies of my own. 
And since the great object to be 
sought after in the investigation 
of this subject, is the collection of 
original testimonies, I have been 
guarded that even the infor mation 
which 1 obtained at Malta, be- 
side the respectability of its au- 
thority, should come with the 
additional recommendation of 
having emanated from the very 
fountain head of experience. 



XXXiv EPISTLE DEDICATORY. 

When I venture to 
draw upon the details of other 
times, it will be understood as 
merely with the view of illus- 
trating some particular points 
by a parity of instances of ac- 
knowledged credit. 

Before closing my letter, 
which I regret to find has so far 
exceeded its appropriate object 
and limits, I would implore a 
patient, and I do not despair, it 
will be an indulgent perusal of 
these pages : trusting that no ob- 
jection can be fairly taken, even 
by the most fastidious of my read- 
ers, to the manner in which the fol- 
lowing discussion is conducted. 



EPISTLE DEDICATORY. XXXV 



Having but little leisure, 
and still less inclination, to 
enter the lists of controversy 
with any who may differ from 
myself, this work must be left 
without an advocate, to stand or 
fall by its own merits. Whe- 
ther it possess any redeeming 
quality to justify my sacrificing 
so much of your time, or that 
can present any claim to the dis- 
tinction of its Dedication, I must 
not presume to have an opinion ; 
but of this I am certain, if the 
observation be allowable from 
one of yourselves, that no one 
more fully appreciates your high 
and liberal attainments, or can 



XXXVI EPISTLE DEDICATORY. 



be more ambitious of deserving 
your consideration, than he who 
has the honor to subscribe him* 
self, 

Gentlemen, 

Your devoted 
and 

Very faithful Servant, 
Arthur Brooke Faulkner. 



Cheltenham, May 10, 1820. 



ADVERTISEMENT. 



Various accidents, not to be foreseen^ 
have embarrassed and impeded the execution 
of this Work, of which it is unnecessary 
that I should take particular notice. I have 
alluded to them merely to account for any 
oversights occasioned by the interruptions of 
a profession which I could not control. 

Among other matters of most importance 
in the following details, I would especially 
advert to the topographical description of 
the casals, in which, from the difficulties of 
obtaining satisfactory information on so 
great a variety of particulars, it is very pos- 
sible I may have been led into some mis- 
takes. However this may be, I feel confident 
that there are no errors of such magnitude 



ADVERTISEMENT. 



as in any degree to affect the general ques- 
tion. When I speak of hills, eminences, 
and vallies, it will, of course, be understood 
by those who have any knowledge of Malta, 
that only slight inequalities of the surface 
are signified, and very different from what 
we are accustomed to understand by the 
same expressions applied to other coun- 
tries. 

The facts which I have brought forward 
both positive and negative, with the view of 
supporting the doctrine of contagion, may 
be thought tediously, perhaps unnecessarily 
multiplied ; yet when I contemplated the 
difficulty of producing conviction on a ques- 
tion so much controverted, it seemed to me 
a safer alternative to err on the side of prolixity 
than to risk the inferences which might be 
drawn from a limited evidence. Some objec- 
tion may also be taken against the long list 
of quotations cited at p. 194, as they do not 
all properly bear reference to the Plague. 
I designed them only to shew how familiar 
the ancients were with the idea of contagion, 



ADVERTISEMENT. 

and, therefore, how gratuitous it is to pre- 
sume that it should have been overlooked in 
a disease presenting so many striking de- 
monstrations of being propagated by contact, 
as the one in question. If the reader should 
have any desire to see this list extended, 
without the trouble of consulting the ori- 
ginals, he has only to turn to the publica- 
tions of Mead and Bancroft. 

After the pains which I have bestowed to 
fix the meaning of the terms contagion and 
infection , it perhaps was not strictly proper 
that I should have used them so indiscrimi- 
nately. This arose merely from a wish to 
avoid the perpetual recurrence of the same 
word, and it appeared to me a venial licence, 
according to the definitions I have adopted. 
I admit also, that the import of these terms 
would have been more correctly settled by 
the prevalent use of the best writers of mo- 
dern times, rather than the standard I have 
chosen. It was, found however, impossible 
to avail myself of such authority, since 



ADVERTISEMENT. 



even the most reputed of the moderns em- 
ploy them in senses widely at variance*. 

It is necessary to remark, in regard to the 
distances between the casals, stated in the 
Fourth Chapter, and likewise as laid down 
in the map prefixed to this Volume, that 
they are estimated in the former from the 
confines of one town to the confines of an- 
other—whilst in the map, the casals being 
represented by mere points, on account of the 
smallness of the scale precluding a fuller 
delineation, the distances, as measured by 
the scale, are necessarily greater than in my 
statements ; and thus their apparent dis- 
agreement will be fully accounted for. 

Upon the whole, I would willingly flatter 
myself, that whatever may be the defects of 
this performance, the unprejudiced reader 

* The truth of this will be placed in a striking potnt of 
view by the evidence of the different medical authorities, 
examined before the Contagion Committee of the House of 
Commons last year. 



ADVERTISEMENT. 



who shall honor me with a patient attention, 
will still see sufficient grounds to bear out 
the view of the question which I have been 
led to entertain. 



Cheltenham, 24th August, 1 820. 



CONTENTS 



CHAPTER I. 

Page 

Preliminary remarks on Malta and Gozo, in respect to 
certain local advantages, conducive to the health of 
the inhabitants; Climate— Soil — habits of the peo- 
ple, &c «... 1 

CHAPTER II. 

The chief causes which have led to errors on the 
question of Contagion 23 

CHAPTER III. 
Sect. I. 

Proof of the contagious nature of the Plague, drawn 
from the contamination of Valetta after the arrival of 
the infected vessel, San Nicolo. ••••••«.. 42 

Sect II. 

Proofs taken from its extension to the individuals who 
were infected by communicating with the first case in 
Valetta, and from its extension to the Augustin Con- 
vent. » « . .v «. 61 



CONTENTS, 



Sect JIT. 

Page 

Proofs drawn from its extension to certain of the 
casals, and to the island of Gozo. • ••• 72 



CHAPTER IV. 
Sect. I. 

Farther evidence of the contagious property of the 
Plague, taken from the extent of contamination in 
each of the casals, as influenced by their locality — 
their distance in respect to the principal sources of 
contamination, and other circumstances. < • • 87 

Sect II. 

Considerations deduced from the preceding details. • • 114 



CHAPTER V. 
Sect. I. 

Evidence continued, drawn from considerations which 
shew that an impure state of the atmosphere is in- 
sufficient to account for the generation of the Plague; 
and, first, of filth, crowding, and want of ventilation, 
as supposed causes of a pestiferous atmosphere. • • • • 121 



CON TENTS. 



Sect II. 

Page 

Of a latent alteration in the state of the air, as a sup- 



posed pestiferous cause. « • • • • ...... 135 

Sect III. 

Marsh miasmata, considered as the source of pesti- 
ferous atmosphere 15L 

Of the temperature of the air, as accounting for the dis- 
appearance or fluctuations of the malady. • 157 

Objections to the contagious doctrine answered • • • • 179 

Differences in susceptibility, illustrated by chemical an- 
alogy - 183 

Ditto by reference to the effects of various agents on 
the human body 188 

The opinion that the Plague arises at certain determi- 
nate periods of the year unfounded • • • . < 191 

CHAPTER VI. 
Of the prevention of the Plague 197 

CHAPTER VII. 

Observations on the Plague as it lately occurred in 

Malta •• 220 

Of the Symptoms 22 L 

Prophylaxis 230 

Treatment 234 

Of Mercury 243 

Cold Water - 246 

Cases under the Author's charge in the Military 

Plague Hospital 258 

Concluding remarks on Absorption >> >>.,,», 274 



ERRATA, 



LETTER TO THE COLLEGE. 
For five read six, p. 18. ]. 10. 



P. 4, I. 17, dele more, — p. 14, !. 14, after bat insert a— p. 36, I. 20, /or 
fortori read fortiori — p. 56, I. 14, dele immediate — p. 60, I. 21, for E read 
A —p. 70, I. 15, after itself insert ?. — p,72, 1. 11, dele the prison — p. 76, 
I. 5, for be read being.— p 90, I. 16, for sixty read fifty — p. 100, 1. 17, for 
application read appellation — p. 117, I. 6, dele Mosta — p. 131, 1. 11, for 
cause read principle — p. 139. 1. 20 — dele himself — p. 143, I. 12, after 
Tuscany insert " — p. 146, 1. 11, for importantly read important — p. 150, 
1. 14, after hospital insert or — p 153, 1. 2, after Floriana insert only — 
p. 161, 1. 1, and p. 168, I. 1, for P. M. read A. M. and vice versa— p 
176, 1. 1, for decrescir read decrescer — p. 191, 1. 3, for attributable read 
attributed— p. 213, 1. 10, for follows read follow— p. 218, 1. 16, for 
dedie read dediee — p. 222, 1. 6, for sanguinous read sanguineous, and 1. 15 
for distant read distinct — 231, 1. 7, for only read alone — p. 239, I. 2, fos 
operations read operation — p. 256, 1. 25, dele in some. 



TTA- 




San 



inn 



REFERENCES. 

A Salvatore JiorcjsJfouse 

B Gate leadi nq to the Count?'*/ ! 

C De Holies Barracks 

\ 

E J#<w ofMarsa?nuchet 
Harlan r in which theffayue 
Ship lay 
F Barracks of //J*Jtegt ment 
G Agustine Convent 




TREATISE 

ON 

THE PLAGUE. 



CHAPTER I. 

Preliminary Remarks on Malta and Gozo, in respect to 
certain local advantages, conducive to the Health of the 
Inhabitants. The Climate — Soil, &c. 

Valetta, which is the chief city of 
Malta, stands upon a calcareous rock, sur- 
rounded on three sides by the sea ; and, in 
consequence of the rectangular position of the 
streets, is thoroughly perflated on every quar- 
ter by the pure sea breeze. It enjoys be- 
sides a great convenience in being situated on 
a declivity, the rock, in many places, sloping 
into the form of a glacis, so that the heavi- 
est shower of rain, if succeeded by a few 

B 



2 



PRELIMINARY 



REMARKS 



hours of fair weather, entirely disappears 
from the surface. Valetta is, therefore, not 
only free from damp, but always remarkably 
clean, being provided with subterraneous 
channels to drain off all impurities. The 
houses are, in general, of a very superior 
order of architecture, many of them much 
more resembling palaces than the habitations 
of private persons, To these advantages it 
may be added, that every part of the 
town is abundantly supplied with excellent 
fresh water, by means of an aqueduct, and by 
public and private cisterns. When we con- 
template a combination of circumstances so 
peculiarly favourable, there is little difficulty 
in accounting for the remarkable good health 
enjoyed by the inhabitants of this populous 
city — a blessing of which they seldom expe- 
rience any considerable interruption. 

The rectangular plan of Valetta is calcu- 
lated to afford peculiar facilities to a vigilant 
Police for arresting the progress of a conta- 
gious disease, by enabling them, at a glance, 
to see and to check any disorderly conduct 



ON MALTA AND GOZO. 



3 



or disobedience to their commands. About a 
dozen of centinels, stationed at the intersec- 
tions of the streets, might observe every 
thing going on from one end of the town to 
the other, and without moving from their 
stations. In short, if a Lazaretto had been 
designed upon a large scale, nothing could 
have more happily answered the pur- 
pose than this city, in point of situation, 
salubrity, and the disposition of its main 
streets. 

The promontory on which Valetta is built, 
was anciently called Scheb-e-ras, signifying 
in Arabic, A place elevated above another; 
and it was, in fact, on account of its com- 
manding and healthful position, that this part 
of Malta was selected, in preference to every 
other, for the site of the Grand Master's 
Palace, and the chief city of the Island. 

In respect to the produce of the soil, there 
is hardly a foot of the rock which has a co- 
vering of mould that is not eagerly laid under 
contribution either for raising corn, cotton, 
fruits, or garden-stuffs, and every season 



4 



PRELIMINARY REMARKS 



yields the most abundant crops of each ; 
so abundant, indeed, is the produce, that, 
Sicily itself, though the once-famed Granary 
of Rome, fails to produce any thing like so 
great a return, in proportion to the extent of 
surface under cultivation, as this little spot. 

Were it not for the rude and unsightly in- 
terference of quarries and stone ditches, the 
Island would present a pleasing aspect, 
as every little paddoc is cultivated with 
so much care and neatness; but the face of 
the country, when viewed in perspective, 
is certainly far from prepossessing. A ge- 
neral officer, on his first visit to Malta, being 
asked what he thought of the Country, re- 
plied, in terms very expressive of its appear- 
ance, that it was much more like to a 
" stone-cutter's yard." — Nearly the whole of 
the Island, lying to the westward, is a barren 
waste, presenting little beside the bare bones 
of Nature, which, in all probability, will 
never be clothed. This arises from the dif- 
ficulty of covering its rugged inequalities with 
earth; and because the rain would more tea- 



ON MALTA AND CxOZO. 



5 



dily wash it away in those places than where 
the rock is more horizontal. To guard against 
this mischief as much as possible, the fields 
are narrowly inclosed by walls, in some 
places of considerable height, which serve 
as a shelter against the combined force of 
storm and rain. I have gone into this de- 
tail of the soil * and surface, in order that the 

* Bridone has the following remarks on this subject, 
which, as they so clearly agree with the statement here 
presented, I shall make no apology for extracting : 

" The aspect of the Country is far from being pleasing. 
The whole Island is a great rock of very white freestone ; 
and the soil that covers the rock in many places is not more 
than five or six inches deep; yet, what is singular, we 
found the crop, in general, was exceedingly abundant." 

And, in another place, — " The industry of the Maltese in 
cultivating their little Island is inconceivable. There is not 
an inch of ground lost in any part of it; and, when there 
was not soil enough, they have brought over ships and 
boats loaded with it, from Sicily. The whole Island is full 
of inclosures of freestone, which gives the face of the 
Country a very uncouth and very barren aspect. The in- 
closures are very small and irregular, according to the incli- 
nation of the ground, This, they say, they are obliged to 
observe, notwithstanding the deformity it occasions ; other- 
wise the floods to which they are subject, would soon carry 
off their soil." 



6 



PRELIMINARY 



REMARKS 



advocates for the generation of Plague, by 
noxious exhalation from the ground, may see 
how far they are deprived of the benefit of 
such an hypothesis, when applied to a 
country like Malta, and to a city like Valetta. 

To the above description it is essential to an- 
nex, that there are only three spots on the ha- 
bitable part of the rock which can deserve to 
be called marshy, or even moist, the Marsa, 
Messida, and Puales ; but it will hereafter 
be shewn, that these places exerted no 
sort of influence in producing the Plague 
being not only remote from the towns which 
were first assailed, but having, indeed, very 
few cases of the disease in their vicinity. 
This was the more remarkable in respect to 
Messida, as it is situated near to a populous 
place or suburb of Valetta, called the Pieta : 
moreover, there are neither rivers, planta- 
tions, (except a few orange groves), or mo- 
rasses, in any part of the Island. 

Malta enjoys the advantage of some of 
the finest ports and harbours in the Mediter- 
ranean : and I have, therefore, been sur- 



ON MALTA AND GOZO. 7 

prised, that some of those harbours which 
lie most out of the reach of communication 
with the inhabitants, have not from early 
times, been pitched upon as places for per- 
forming the quarantine of suspected vessels. 
It will be seen in a subsequent part of this 
Volume, that when I submitted a proposi- 
tion to the Government of Malta for sending 
all vessels suspected of having the Plague 
into one of those harbours, the idea had not 
hitherto been acted upon. The information 
which I possessed on this subject, exclusively 
bore reference to Saint Paul's Bay, as the only 
one which I conceived perfectly adapted for 
a secure anchorage in all weathers. I have 
heard it observed, however, that there are 
other harbours which, on an emergency, 
might be occupied at certain seasons as 
quarantine stations, the principal of which are 
Marsascalatothe eastward, and Marsascirocco 
towards the south-west, each capable of 
containing a good number of vessels : 
and at the very extremity of the Island to- 
wards the west, there is a creek, or cove, which 



PRELIMINARY 



REMARKS 



is said to be well adapted as a road even for 
ships of considerable burthen. But though 
ajiy, or all of these ports, might be convertible 
into temporary quarantine harbours, doubtless 
Saint Paul's Bay * is, of all others, the most 

* The following description given of this harbour by Briar- 
ley, Master of Lord Nelson's ship during the siege of 1801, 
was that upon which I founded the above-mentioned propo- 
sition to the Government—*' The harbour of St. Paul's is 
open to easterly and north-east winds ; notwithstanding 
which, it is safe for small ships, as the ground is very good; 
and while the cables hold, no danger, as the anchors will 
never start. The best anchorage is abreast the small harbour 
on the starboard hand going in, from ten to six fathoms soft 
mud and clay. Small ships may haul into the little harbour 
and lash together in a tier, having an anchor out to S. S. E., 
and no winds can hurt them. There is no danger going in, 
except a small reef otF the point of Salmonetta, about half a 
cable iu length ; give it a birth of about a cable, and this 
will carry you clear of every thing." 

That there might be no mistake, I also consulted the 
Master- Attendant of the Malta Dock- Yard, and obtained 
from him a letter, couched in these terms : — 

" The state of my health will not allow me to give you 
so full an account of St. Paul's Bay as I could wish, but 
trust the undermentioned will answer your purpose. The 
only danger in going into the Bay is a short reef of rocks 
that extend from an Island on the north side, called Solo- 



ON MALTA AND GOZO. 



safelv circumstanced for vessels to ride out 
the severity of the winter gales. Indeed 
the experiment has already been tried with 
perfect success ; and since my propo- 
sal was first submitted for sending sus- 
pected vessels to this Bay to perform their 
quarantine, it has been much occupied, and 
found so convenient, that ships have an- 

mon's Island, (Salmonetta), by holding about half a cable's 
length from it, you will keep clear. Having passed this 
Island, and standing into the bay, you will open a small 
Bay on your starboard hand, which is nearly opposite St. 
Paul's Castle. In this place, during the blockade which I 
was nineteen months on, we put all our prizes ; and many of 
the vessels belonging to the Island lay there also. I have 
been anchored in a seventy -four gun ship in St. Paul's 
Bay in a heavy gale from the N. E., with a great sea, 
and obliged to strike lower yards and top-masts, and 
the prizes have lain as quiet in this small Bay, as if they had 
been in the most secure part of Valetta Harbour, and this 
was during the winter months." 

(Signed) " W. LAWSON." 

Master- Attendant of 
Valetta Dock-Yard, 



10 PRELIMINARY REMARKS 



chored there throughout the most incle- 
ment season, without any accident or un- 
toward circumstance, worthy of being noticed. 
One especial advantage possessed by St. 
Paul's Bay arises from the contiguity of the 
small Island of Salmonetta, which, I believe, 
is not much less than half a mile in length, 
and would admit of a commodious Lazaretto 
being erected upon it, besides affording the 
necessary facilities for embarking and dis- 
embarking in all weathers. This little Island 
was used, during the late Plague, for the 
erection of temporary magazines, to receive 
infected stores. It was likewise occupied by 
the sick and suspected crews of vessels per- 
forming quarantine, and found extremely 
well adapted to all these purposes. 

I have heard that the Knights of Malta had 
it long in contemplation to erect a Lazaretto 
on Salmonetta ; but I am unacquainted with 
the causes that hindered the completion of 
this design ; as, doubtless, so convenient a 
provision against the introduction of Plague, 
would be an invaluable resource to a country 



ON MALTA AND GOZO. 11 



which has so much commercial intercourse 
with the Levant. 

The climate of Malta, though hot, is fa- 
vored by many advantages. There are rarely 
any fogs or vapors, and, unless in the months 
of January, February, and March, the sky 
is one continued azure, with seldom a cloud 
to intercept the rays of the Sun. In regard 
to heat, I believe some part of the summer 
season comes little short of what is expe- 
rienced in the West Indies, the thermometer 
ranging from about 75 to 85 in the shade. A 
late writer* has, I think, rather over-rated this 
matter, in stating " that the heat is greater 
during eight months, than in either the East 
or West Indies/' This mistake may have 
proceeded from a deception of the sense, pro- 
bably, from the oppressive languor caused by 
the sciroc wind, which, from its relaxing 
quality, imparts a sensation of being much 
warmer than the thermometer indicates. 

Sudden transitions from heat to cold are 
felt in a remarkable degree when the wind shifts 

* Genera) Cock burn. 



PRELIMINARY REMARKS 



from a southern to a northern point; this, 
however, is not peculiar to Malta, but is expe- 
rienced in most parts of the Mediterranean, 
near the coast of Africa. Should the wind 
change suddenly from a northern quarter to 
S. E., from which latter point the sciroc blows, 
it is frequently attended with a rise of not less 
than 20 degrees. When we consider the in- 
fluence which so great a vicissitude is likely to 
exert over the human frame, especially if weak- 
ened by previous disease, or by any other 
cause, it seems almost incredible, that very 
hurtful effects do not generally ensue :— 
but this is never the case ; and the most 
delicate habits will emerge from three or 
four days of sciroc, with as much impunity 
as if the temperature had been perfectly 
uniform and moderate. A change from sciroc 
wind imparts to most people a feeling of 
elasticity and exhilaration not unlike what is 
experienced after a cold bath in sultry wea- 
ther. Yet these agreeable sensations do not 
depend always upon the transition from an at- 
mosphere that is actually more heated, as the 



ON 



MALTA AND GOZO. 



13 



thermometer often points out a higher degree 
of real heat afterwards, than during the pre- 
valence of this wind : shewing that the effect 
upon the human body arises from something 
peculiar in the quality of the wind, and which, 
probably, will for ever elude detection. To 
assume, as some have believed, that the 
relaxing and depressing effects of the sciroc 
depend upon any impregnations acquired by 
it in passing over the barren, sandy, and 
burning continent of Africa, seems rather a 
plausible than a satisfactory account of the 
matter, since it is almost inconceivable, that 
any impregnations of this kind should not be 
dissipated or diluted during their passage 
over the intervening sea. 

The seasons of one year do not differ ma- 
terially from those of another ; nor is there, 
perhaps, any part of the world where the tem- 
perature continues more equable. There is, 
in fact, but little variable weather, excepting 
about the early part of the spring, or the be- 
ginning of February, when the quantity of 
rain is often very considerable ; and the 



14 



PRELIMINARY REMARKS 



gales are so tempestuous, particularly from 
the N. E., as to turn small craft upside 
down in the harbours. This wind is called 
by the natives, " Gregalia," and is the same 
with the Euroclydon, which proved so dis- 
astrous to St. Paul. Snow and ice are sel- 
dom seen: when they do occur, their visit 
is a very transient one. There are, however, 
frequent and heavy falls of hail ; and some of 
the grains so very large and angular, as to 
resemble broken fragments of ice. During 
hot summer weather, the night is the most 
oppressive part of the twenty-four hours, 
there being but few degrees of differ- 
ence in their temperature: in consequence 
of this uniformity in the heat of the day and 
night, the dews are inconsiderable, except- 
ing when the sciroc-wind prevails ; but, even 
then, they are slight and evanescent. Thun- 
der and lightning are not unfrequent occur- 
rences ; nor can anything be imagined more 
awfully magnificent than the sky, dressed in 
all its gloomy terrors, whilst the vivid flashes 
dart across the horizon in rapid succession. 



ON MALTA AND GOZO. 



15 



The thunder-peal is truly terrific, and has 
often brought to my recollection the following 
passage, in which its effects are described 
with such majesty:— 

" Quo bruta tellus, et vaga flumina 
Quo Styx, et invisi borrida Taenari 
Sedes, Atlanteusque finis 
Concutitur " 

On these occasions the rain falls in torrents, 
but is soon over, and the sky resumes its na- 
tural serenity. 

The quantity of corn grown in the Island 
is unequal to the consumption of more than 
one-third of the population ; but, as large 
supplies are constantly imported from Barbary 
and some of the neighbouring coasts, Malta 
is enabled, out of its stores, not only to pro- 
vide against the wants of its inhabitants, but to 
spare a great deal for exportation ; and, upon 
several occasions, Sicily itself has had to apply 
to the granaries of the * Universita in times of 
scarcity. The people are, therefore, not 

* The Univemta is a body of magistrates, part of whose 
duty it is to provide coin and regulate its sale and prices. 



16 



PRELIMINARY 



REMARKS 



often exposed to a visitation of the miseries 
attendant upon a dearth of wholesome pro- 
visions. 

There are about twenty-four small towns, 
or casals, all of which are built of hewn stone, 
and the very meanest of the houses are 
commodious and healthful. In these re- 
spects, the villages of Malta are, perhaps, 
superior to those of any other country in 
Europe. There is, besides, a sprinkling of 
country houses and hamlets for the more 
convenient accommodation of those occupied 
in the culture of their farms and gardens. 

The natives are healthy, active, strong, 
industrious, and sober ; and so devoted to 
their country, as to think no other on the 
face of the earth can come into compa- 
rison with it. Hence they dignify it with 
the title of " Fiore del Mondo." Their 
diet is simple, consisting of vegetables, mac- 
caroni, fruit, eggs, oil, cheese, honey, and 
a little animal food, (for the most part fish,) 
and they are very temperate in the use of 
wine and spirits. 



ON MALTA AND GOZO. 



17 



It remains only to say a few words of the 
contiguous island of Gozo, which appellation, 
in the Maltese language, denoting " Joy/' was 
imposed, no doubt, on account of the great fer- 
tility of the soil, and every other advantage con- 
ducive to health and comfort which it so emi- 
nently possesses. Gozo, though standing higher 
than Malta, has a leveller surface, and, in con- 
sequence, gives less trouble to the husband- 
man, and makes a better return to his labours. 
The soil is of the same quality as that of the 
neighbouring island, but deeper, and it enjoys 
the convenience of many abundant springs of 
fresh water. The dimensions of Malta do not 
exceed twenty miles in length, and twelve at 
its greatest breadth ; nor is Gozo much above 
nine long and about five broad. 

If the above be an accurate sketch of these 
Islands, it must be allowed that there is, at 
least, no prima facie evidence of their being 
liable to generate pestiferous miasmata. 
Whether we consider the narrowness of their 
extent, the superior description of the 
houses, the dryness and quality of the soil, 
or the habits of the people, it is, perhaps, 

D 



18 



PRELIMINARY REMARKS 



impossible to conceive any part of the world 
where the inhabitants can be less exposed to 
the morbific influence of local causes. But, 
as it will form the business of a future chapter 
to enter more minutely into the detail of this 
subject, 1 shall dismiss any farther notice of 
it, for the present. 

I close this outline with a copy of verses, 
never before published, and written by a 
Maltese priest just before his decease. As 
they are descriptive of the island, the 
simple character of the people, and, more 
than any thing, an enthusiastic attach- 
ment to their country, it may not be an un- 
acceptable morceau to some of my readers. 
In other respects, they have, I am aware, 
little to recommend their appearance before 
the public. Yet, humble as the author's 
pretensions certainly are, to any great share 
of the afflatus divinus of his great proto- 
type, in pastoral composition, it is but fair 
to observe, that this little Poem was written 
under the pressure of sickness, and, therefore, 
at a season when the mind may be supposed 
but little fitted for the labour of revision. 



OK MALTA AND GOZO. 



19 



DE INSULIS MELITVE et GAULI 

Fingitur in Publii casa esse tabulam topographicam Insu- 
latum MelitcB et Gauli, de qua Pastores sermonem 
instruunt. 

DIODORUS et PUBLIUS. 



Diodor. Muro quaenam fixa tenes incognita signa? 
Urbano anne modo sylvestria tecta decoras ? 
Cur potius madida non pendet cantharus ansa ? 
Cur potius Citharae non pendet amabile pondus ? 

Pub. O Diodore tace — Patriae non cemis in illis 
Expressam formam, neque patria litora noscis ? 
Detulit hanc tabulam civis mihi nuper amicus. 

Diodor. Parce precor Publi, pecoris custodia semper 
Me tenet, et patrios prohibet cognoscere fines. 
Nunc equidem video sparsas per litora turres 
Et geminas cerno disjunctas gurgite terras 
Quas inter Scopulus mediis circumdatur undis. 

Pub. Est major Melite, quae piscis tenditur instar 
Portubus inlustris, multis habitata Colonis, 
Et minor est Gaulos, scopulusque est ille Cominus. 
Hie ubi prorumpit tellus, geminique creantur 



20 



PRELIMINARY 



REMARKS 



Portus Valettae, et reliquae sunt cominus Urbes 
Quas cingit Cotonera altis tutissima muris. 
£n Portae, en turres ! en propugnacula belli ! 
En merces variae, en tuta statione carinae ! 

Diodor. At quid longinquo depictum est culmine montis! 

Pub. Urbs ibi prisca jacet, nostrorum clara parentum 
Sedes, usque adeo tantas vestigia molis 
Prostant marmorei lapides, fractaeque columnae : 
Urbis splendorem tantis tu disce ruinis. 

Diodor. Est equidem ! Melitae media, atque in parte 
superbit : 

Illic ire juvat, populo comitante quotannis 
Cum Pauli festiva dies celebratur ; ibique 
Prapmia saepe tulit currendo mula Parentis. 

Pub. Urbi quae vicina sedet pulcherrima moles 
Villa est Verdola annosis circumdata sylvis 
Hanc juxta nuper Prcesul Durinus amaenas 
Aedes construxit, pingues ubi copia aquarum 
Iteddit agros ; est hie Durinus scilicet ille 
Nomine Crisauri Arcadicis sat notus in arvis. 
Egregios istic fructus dat terra, thymoque 
Roscida mella illic fiunt redolentia passim. 

Diodor. Haec quas circumstant, sunt oppida cognita 
nobis 

Quae circum effodimus nummos, idola, lucernas, 
Telluris gremio prisci vestigia ritus. 
At qua? percurrunt Meliteusia litora puppes 
Jgnitae? Cur tot numero bellumque minantes ? 

Pub. Sunt has Turcarum, piget heu mernorate phalanga^ 
Tent^runt olim nostram qui vincere terram. 
I^estitit at virtus nostiorutn mascula Patru.m 



ON MALTA AND GOZO. 



21 



Enituitque adeo, penitus quod pelleret Hostes. 

Diodor. Non ignoro equidem, haec proavus narrare 
solebat 

Cum jam perfecto languerent membra labore 
Et narrabat uti Turcee per rura vagantes 
Virginis excusam sanctae rapuere rlguram 
Ipsa sed ingemuit, Numenque vocavit amicum ; 
Audivere sui clamores Virginis, atque 
Unanimes, fusis Turcis, torrentis ad instar, 
In templo statuam rursus posuere redemptam 
Gaulum et tentarunt aliquando invadere Turcae ; 
Tunc Siculus miles sese cum prole necavit 
Effugiens hostis constanti morte ruinam ; 
" Tantum libertas potuit suadere malorum !" 

Pub. Extrema Melitse stans hoc in parte sacellum 
Virginis illius sacrum est; quam ssepe solemus 
Vexati curis precibus votisque precari. 
Non procul hinc Paulus disrupta nave per aequor 
Appulit, et nostros docuit sacra dogmata Patres ; 
Hinc Portus Pauli nomen retinebit in oRvum. 

Diodor. Non me tanta latet, cunctis notissima fama : 
Hinc pietas Melitensis, adhue florescere gentis 
Visa est, neque ullo deletur tempore ; fulget 
Sat pietas nostrum, si tot celebenima templa 
Passim conspicias, tangentes sidera moles. 

Pub. Montibus en Gaulos Melita magis eminet; illic 
Pastores superant nostros, Diodore, labores. 
Jirachia mille modis medias jactare per Undas 
Cerne hie turriti nascentia maenia castri 
Quod generosus Eques Pinto sub principe condit 
Quae procul apparet contermiua nubibus ora 



22 PRELIMINARY REMARKS, &C. 



Trinacriae est Regnum, vicinaque terra Pachini; 
Quae propior picta est sterilem dixere Cocyram. 
Quae verum longe distant, ubi respicis austrum 
Sunt Lybiae syrtes, et Punica litora quondam 
Inlustres urbes, sed nunc horrentia Regna. 
Quam longe pateat pelagus modo respice utrumque 
In latus occidui Solis, solisque orientis ; 
Parvulus hie scopulus deserta est Tulfula ssepe 
Quam nostra accedit captura Juventa Volucres. 

Diodor. Plura equidem vidi visu dignissima, nostra est 
Tellus exigua, et terrae non invidet ulli, 
Naturae dotes si contempleris, et artes 
Pervigiles hominum. 

Pub. Hinc est dedita gloria nostrum 

Famaque nostra micat, terraque marique per orbem. 

Diodor. At satis : ecce dies jamjam decrescit, in undas 
Se sol submisit, non amplius umbra videtur. 

Pub. At nox errantes suadet me ducere capras 
Hos alias reliquos patriae dicemus honores, 
Ducemus choreas, voci et sociabimus artem. 



28 



CHAPTER II. 



Of the chief Causes which have led to Errors on the 
Question of Contagion. 

Before entering on the proofs, by which 
it is proposed to demonstrate the contagious 
character of the Plague, it seems to me ne- 
cessary to premise a few observations relative 
to the more frequent causes which have led to 
erroneous conclusions on the subject of conta- 
gion in general ; as it is from the influence of 
these, that much discordance of opinion has 
originated ; and, indeed, not only in reference 
to the present question, but on every other 
connected with pathological enquiry. 

I have not considered the obviousness of 
the remarks I am about to offer, a sufficient 
reason for passing them over as superfluous, 
since the least reflection must convince us, 
that those truths, which cost the least effort 
to discern, are always the most liable to be 



24 OF THE CHIEF CAUSES OF ERROR 

overlooked or undervalued; and this with- 
out any regard to their intrinsic importance. 

The causes of error to which I refer, pro- 
ceed either from 

The instability of the condition of the 
living system ; 

The ascendency which opinions and pre- 
judices obtain over the judgment; 

Indolence in the investigation of facts ; 

Or, lastly, from too precipitate and in- 
cautious a use of facts. 

I hope, by dwelling upon each of these 
sources of fallacy somewhat in detail, that 
the reader may be better prepared to exercise 
his judgment independently, as well as more 
circumspectly, on the question before us ; 
secure, at least, from the deceptions of 
merely plausible reasoning, or ingenious mis- 
application. 

Against those errors, which are liable to 
arise from the instability of the condition of 
the living system, it is to be feared, that no 
sagacity or caution can ever be expected 
wholly to provide. Fallacious as our deduc- 



IN OUR REASONING ON CONTAGION. 25 

tions are so frequently discovered to be, when 
drawn from the operation of inert substances 
upon each other, the uncertainty of their 
truth becomes incalculably greater, when we 
would investigate the principles by which 
living matter is acted upon. Hence, even 
with the most wary caution, to suspend 
coming to any conclusion which is not borne 
out by just rules of philosophizing, the 
difficulties in the way of obtaining cor- 
rect notions on the subject of contagion 
are peculiarly discouraging. If, as in Na- 
tural Philosophy, or Chemistry, we could 
depend upon having the phenomena presented 
to us at the different times of our examining 
them, precisely under the same circumstances, 
we should then have possession of a rich field 
of discovery. But, unfortunately, so many 
and such various accidents are liable to modify 
the state of the human body, as well as so many 
collateral influences, to obscure the agency of 
any morbific cause which acts upon it, that 
it seems hardly possible to disentangle the 
investigation, and to distinguish, with con- 

E 



26 OF THE CHIEF CAUSES OF ERROR 



fidence, between real and apparent results. 
It is this uncertainty which, principally, oc- 
casions the discordance of opinion we find 
among writers on pathology, and that from 
the earliest ages of Medicine, has continued 
the inexhaustible source of theories and sys- 
tems, the most plausible of which have 
proved, at length, to be little more than in- 
genious speculations, and accordingly, are 
now exploded or forgotten. — -From these con- 
siderations a sober lesson is derived, which, I 
need hardly observe, ought to produce in us 
a due distrust as to the stability of any 
theories we may ourselves be adventurous 
enough to build up. 

As to the ascendency which opinions and 
prejudices obtain over the judgment, a fre- 
quent occasion of fallacy is an undue import- 
ance bestowed upon the writings of the an- 
cients. Some are infatuated with so blind a 
respect for every thing antiquated, in point of 
authority, as to give only a reluctant credit to 
any opinions which are at variance with the 
infallible names of Hippocrates, Galen, or 



IN OUR REASONING ON CONTAGION. 2 "7 

some ancient father of the Art. A philo- 
sopher of this school realizes the observation 
of the satirist : 

11 et nisi quae terris semota suisque 

" Temporibus defuncta videt, fastidit et odit." 

But, although it must be admitted, that 
the writings of antiquity contain much va- 
luable information, and are often entitled to 
a high degree of our respect, from the in- 
ternal evidence which many of them furnish 
of laborious and unsophisticated zeal in the 
cause of truth, yet, it is no less certain, that as 
much caution is necessary in adopting prin- 
ciples from these sources, as whilst exploring 
the volume of Nature itself. It is, perhaps, 
more remarkable of Medicine, than of 
any other tentative science, that, through- 
out all ages, up to the present day, even the 
most illustrious of its professors, have been 
much drawn away from the contemplation of 
particulars, to indulge in generalities, and 
abstract speculation ; so that, in short, with- 
out a very watchful guard upon the under- 
standing in the perusal of any writers, whe- 



28 OF THE CHIEF CAUSES OF ERROR 



ther of earlier or later date, the Medical 
Philosopher will be in greater danger of 
confirming his mistakes, than enabled to dis- 
cern truth more clearly by their assistance : — 
The business of the Physician, who would 
extract safe and useful principles from the 
records of the Art, is scrupulously to examine 
into the reasonings of his author, and to 
compare them with the facts upon which 
they are rested ; and, if he finds that their 
agreement is just, he will be warranted in 
assenting to the validity of such reasonings, 
provided his own observation be not at va- 
riance with, or do not cast a suspicion on 
the fidelity of the author's statements. But 
if these statements are likewise observed to 
coincide with his own individual experience, 
the enquirer may then, (and, perhaps, not 
until then,) safely congratulate himself upon 
a real accession to his knowledge, 

But, whilst we are cautious to avoid being 
imposed upon by schools and systems, it is 
necessary to be not less careful in steering 
clear of the opposite extreme. Our reason, 



IN OUR REASONING ON CONTAGION. 29 



whilst emancipating herself from the bond- 
age of authority, is too prone to neglect every 
guide but the feeble light derived from indi- 
vidual observation ; and thus, by setting at 
nought the information which others have col- 
lected and transmitted, we virtually renounce 
the utility of all experience, and deliver Me- 
dicine, at once, into the hands of an ignorant 
and degraded empiricism. It is unnecessary 
to dwell at any length in exposing an error of 
so very glaring a description ; yet, there is 
reason to believe, that a disinclination to 
appreciate duly the labours of others, has 
long existed the occasion of much unproduc- 
tive controversy on the subject of contagion. 

It results, moreover, from this spirit of de- 
preciation, that we sometimes discover in the 
works of Medical writers, a disposition to 
treat the opinions of those who dissent from 
themselves with a contemptuous levity, 
equally indecorous as it is inconsistent with 
the character of a learned and liberal pro- 
fession. Still, if we could have any as- 
surance that this conduct proceeded from the 



30 OF THE CHIEF CAUSES OF ERROR 



workings of an honest and independent zeal, 
the motive might, in some degree, extenuate 
the extravagances to which it leads. There is, 
however, too much reason to suspect, that 
many of these authors are but little con- 
cerned about the advancement of knowledge, 
and that the real scope and tendency of 
their writings is aimed at the gratification of 
selfish feeling, — perhaps, the furtherance of 
some object of private interest. Another 
mistake sometimes discoverable in this class 
of reasoners, (if they can deserve to be called 
reasoners,) is the value which they set upon 
the number of plausible arguments that may 
be pressed upon one side of a question. And, 
yet, it is evident, that arguments, however 
numerous or plausible, can afford no solid 
support, unless they are founded on a broad 
and firm basis of facts. It is not a mere 
mass of circumstances collected together from 
whatever source, that ought to constitute 
evidence, but a series of clear and well 
authenticated particulars, converging and 
making in favour of a principle by which 



IN OUR REASONING ON CONTAGION. 31 



alone, and no other, the bearings of the 
question can be most satisfactorily explained. 

Of the sources of fallacy which have been 
just considered, viz. too devoted a respect for 
authority, or its opposite ; the former has, per- 
haps, most generally impeded the progress of 
medical science ; as it begets a passive- 
ness, which totally unfits the mind to put 
forth its powers, or to examine sufficiently for 
itself the truth of the principles it adopts on 
the credit of others. To express the whole 
concisely in the words of a high authority : 
" Obest plerumque iis qui discere volunt 
auctoritas eorum qui se docere profitentur. 
Desinunt enim suum judicium adhibere ; id 
habent ratum quod ab eo quern probant, 
judicatum vident." This leads me to bestow 
a few remarks on the last source of mis- 
taken opinion ; and which is nearly allied to 
the one we have been discussing ; — namely, 

Indolence in the investigation of facts. 

From indisposition to apply its powers in 
the pursuit of new facts, the mind is pe- 
culiarly liable, in a science of so conjectural 



32 



OF THE CHIEF CAUSES OF ERROR 



a character as Medicine, to be seduced 
by the attractions of theory. The field 
of experiment being extensive, and the 
fruits of its cultivation precarious, the la- 
bourers are too commonly disinclined to ex- 
ertion, and, as the exercise of the imagi- 
nation is a much more agreeable occupation 
to most people, than the dry details of expe- 
riment, the understanding is apt to deliver 
itself to opinions which are little else than 
the mere idols of its own creation. No 
class of philosophers are more unwilling to be 
convinced of their errors than these, pride 
being concerned to maintain what they have 
been accustomed to value as the product of 
their ingenuity, and which, if cherished any 
length of time, acquires, in their estima- 
tion, all the force of unquestionable truth. 

If this be a just state of the matter, surely 
none can be more disqualified than such 
persons for advancing a science like Me- 
dicine, whose path leads through so many 
intricate mazes of uncertainty. The great 
Roman orator was well acquainted with this 



IN OUR REASONING ON CONTAGION. 33 

disqualification in the philosophers of his 
own time ; adverting to it, he emphatically 
asks, and the question may be put with much 
justice, in reference to many works of mo- 
dern times on the subject of contagion- 
quid tarn temerarium tamque indignum sa- 
pientis gravitate atque constantia quam quod 
non satis explorate perceptum sit et cognitum 
sine ulla dubitatione defenders 

Of the fourth and last cause of error, the 
instances are not less numerous than of any 
of the former ; and it will be found, that a 
precipitate and incautious use of facts 
is a frequent occasion of dispute in the Me- 
dical World. 

The obscurity which envelopes the opera- 
tion of morbific agents upon the human 
body, gives a pre-eminent advantage to that 
man who possesses the greatest dexterity in 
wresting and accommodating what he ob- 
serves to his favourite opinions. Hence have 
resulted the almost infinite modifications of 
theory on the causation of those diseases, by 

F 



34 



OF THE CHIEF CAUSES OF ERROR 



some termed epidemic, and by others conta- 
gious, certain of which theories have exer- 
cised a more absolute dominion, according as 
they may have been constructed with greater 
or less ingenuity. Nay, by mere adroitness 
in misapplication, it not unfrequently hap- 
pens, that the very same facts and circum- 
stances are made subservient to establish 
systems the most directly opposed to each 
other ; yet each is defended with so much 
earnestness, and delivered in a tone of such 
perfect confidence, that we might suppose 
their respective champions were contending 
for points as obvious as a mathematical 
demonstration. So ready is the foregoing 
abuse to entwine itself with our reasonings, 
that it has even extended to the mathe- 
matical branches. Of this we have no- 
table examples in the theories of Tycho 
Brahe, and Copernicus, which, though so 
essentiallv differing from each other, con- 
tinned, severally, to sway the assent of 
mankind for ages. Yet these theories 
rested upon the same apparent phenomena, 



IN OUR REASONING ON CONTAGION. 35 



and all calculations are found indifferently 
agreeable to both, whether the earth be sup- 
posed to move in the ecliptic, or be only 
allowed a diurnal motion round its axis. 

In short, if we would expect to attain to 
any thing like certainty in our investigations 
of morbid phenomena, our surest chance of 
success must depend on accompan} r ing a 
laborious experimental research, with a close, 
patient, and circumspect exercise of the 
judgment ; otherwise experience will prove 
but a delusive light, decoying us per- 
petually into mistakes, and cheating us of 
the fruits of our labour. We see, for ex- 
ample, in Chemistry, what palpable errors 
have arisen through neglect of these means, 
from the earliest cultivation of the science 
to the present time. Instances without num- 
ber might be cited. To mention one of more 
general notoriety, the principle of levity or 
phlogiston, was, for nearly a century, em- 
braced as a discovery in every part of Eu- 
rope, and continued to maintain its ground 
unshaken, until Lavoisier, and others, by 



36 OF THE CHIEF CAUSES OF ERROR 



more exact experiments, aided by a more 
severe and cautious contemplation of results, 
wholly disproved its existence. — Even in 
Geometry and Mechanics, branches of truth, 
the principles of which are immutable, 
there are not wanting many examples of 
men being carried away by a train of in- 
cautious reasoning, to assent to conclusions 
which all the world know to be fallacious, 
but which, however ? were maintained by 
their authors with the utmost pertinacity. I 
need scarcely mention, as illustrations of this, 
the numerous infallible modes of finding out 
the quadrature of the circle, and the perpe- 
tual motion, which have, at different times, 
been vauntingly proclaimed to the world ; 
with many other such discoveries, equally 
unreal and fanciful. If, then, whilst rea- 
soning on true principles, we are not safe 
from sliding into great errors, a fortori, how 
greatly more are we exposed to deception in 
a science like Medicine, the principles of 
which are so indeterminate. 

Discouraging as the prospect may appear 



IN OUR REASONING ON CONTAGION. 37 

of our ever arriving at any very extensive or 
certain knowledge in the science of Pathology, 
we shall, at least, be safe under the conduct 
of a well regulated experience, from falling 
into either extremes of absolute scepticism, or 
dogmatical self-sufficiency ; extremes which, 
I need not add, are both equally inimical to 
the productive efforts of the understanding. 
If a more serious consideration were bestowed 
upon these things, plain as they may appear, 
we should, certainly, witness much less of that 
acrimony which so often disgraces the pages 
of Medical controversy. Indeed, were a 
Physician truly earnest in the cultivation of 
his Art, he must find his way every where so 
beset with difficulty, and see such frequent 
cccasion to alter his course, or to retrace his 
steps, that the tone of his discussions, in 
place of provoking impatience, would always 
challenge respect and attention ; and, if 
they should fail to engage our assent, 
would, at least, make the best possible pro- 
vision for an impartial consideration on the 
part of his readers. Whilst such a man com- 



38 Or THE CHIEF CAUSES OF ERROR 



municates his opinion, whether they are te- 
nable or otherwise, we plainly perceive 
throughout, that his most earnest aim is the 
attainment of truth . 

It must be allowed, nevertheless, that 
there is no little difficulty in approaching 
certain controverted questions with a mind 
altogether free from preoccupation. Who, in 
fact, can assure himself, that he alone is ex- 
empt from prejudice in some shape, arising 
either from his passions, interest, temper, 
self-love, or some other silently operating mo- 
tive ? Besides, the domination of prejudices, 
we know, is much strengthened by the length 
of time they may have been entertained ; and 
it would be unreasonable to expect, that opi- 
nions which have been long assented to as 
realities, should be surrendered without a 
struggle, even to weighty and conclusive ar- 
guments. Still there must be limits to this 
forbearance, particularly where we find, as 
too often happens, manifest indications of an 
illiberal and even an arrogant disposition, 
under the mask of zeal for the interests of 



IN OUR REASONING ON CONTAGION. 39 



science, since such a frame of mind is dia- 
metrically opposite to the spirit of scientific 
enquiry. *0pi?iionatrete, perhaps, furnishes 
the very best of all proofs, that the positions 
which it would defend, are, in reality, in- 
defensible, and may fairly authorize a sus- 
picion, that their author is striving against 
his conviction at the time he is maintaining 
them. 

I would not have trespassed with the fore- 
going observations, all or most of which, I re- 
peat, must be familiar to every one engaged in 
the pursuit of natural knowledge, but that so 
many instances of daily occurrence shew they 
are too seldom kept in view ; and, perhaps, 
on no other subject, have the above causes 
of error ever prevailed to a greater extent 

* I cannot help lamenting-, that this spirit, which a cer- 
tain author terms a " sturdy unyielding- pertinacity," should 
ever be found to shew itself in the consultations of Physi- 
cians. The egotistical and vulgar obtrusion of our own 
sentiments, however just they may happen to be, not only 
degrades a liberal profession, but essentially impedes the 
full and free exercise of the judgment, by the prejudice it en- 
lists on one side, and the disgust it must excite on the other. 



40 



OF THE CHIEF CAUSES OF ERROR 



than on the question of pestilential contagion. 
Thus we have presented to us almost as 
many opinions as there are writers on this 
subject ; and, I need not add, how obsti- 
nately many of those opinions have been 
maintained, on what slender grounds some 
of them have been taken up — what hostility 
they have produced, and, by consequence, 
what discredit this warfare has brought alike 
upon the Professors and the Profession of 
Medicine. It is, no doubt, a disheartening 
consideration, that so much intellectual la- 
bour has been expended to so little purpose ; 
yet, I persuade myself, the failures have 
arisen more frequently from the disposition 
in which men have set about the enquiry, 
than from any actual inadequacy in the ca- 
pabilities of the human understanding ; in 
short, that our knowledge would be more 
successfully advanced, if, as Locke ob- 
serves, " men would seriously, and with 
freedom of mind, apply all that industry 
and labour of thought, in improving the 
means of discovering; truth, which they do 



IN OUR REASONING ON CONTAGION. 41 

for the coloring and support of a system, 
interest, or party they are engaged in/' 

To conclude : I cannot be ignorant, that, 
throughout the whole of these remarks, I 
have been providing a code of severe laws 
and penalties against myself, and which, 
most probably, may be pointed with effect 
against numerous deficiencies in the pre- 
sent Volume. Should this prove to be the 
case, there still is a consolation arising out 
of the consciousness that I have not neglected 
to avail myself of every opportunity, (and, I 
may add, the opportunities which did occur 
to me were of a very peculiar kind), which 
my experience has afforded, to arrive at 
some well authenticated facts on a question 
of great public importance. Neither have I 
been wanting in an endeavour to use the re- 
sults of this experience in a manner which 
seemed to me best suited to the acquire- 
ment of some useful knowledge. 



d 



42 EVIDENCE OF THE CONTAGIOUS 



CHAPTER III. 



SEC. h 



Facts, in proof of the * contagious nature of the Plague. 



* As it is indispensable, in the conduct of every discussion, 
that the exact meaning of the words upon which it princi- 
pally hinges, should be clearly defined and settled, I think 
it right in this place to make a few remarks on the import of 
the terms infection and contagion. 

Infection is a word of figurative construction, derived 
from injicio to stain, imbue, or contaminate, denoting the 
power or quality of a morbific agent, to contaminate with 
disease ; whether this contamination take place by the air, 
or by contact immediately or mediately with a diseased 
subject. In the latter of these meanings, it signifies what 
both ancients and moderns agree to understand by contagion, 
which, therefore, according to the language of Logicians, 
differs from infection only in being a term of lesser extension. 
The etymology of infection, as here stated, receives farther 




NATURE OF THE PLAGUE. 



43 



gious property of the Plague, under the fol- 
lowing divisions : 

I. The extension of the disease to Valetta 
from the infected vessel, San Nicolo. 

II. Its extension to the individuals who were 



confirmation from the circumstance, that Bap»', which is syn- 
onymous, comes from a similar root, Gairru inficio. 

Thus, contagion expresses only a mode of infection, in 
proof of which we have different passages, both in Greek 
and Roman writers. To take an example from each. Ta- 
citus expresses the whole matter clearly, in the words — 
infecti quasi valetudine et contactu. And the meaning of 
Aretaeus is not less decided to the same effect, when speak- 
ing of elephantiasis, he observes, At'os h fypCtSv rs, xxt 
avvfitxiTapQai, « fAetov ri \ot(xu t ocvonrvovis yoig is /^sracW/y ''p>5$/>) Bxtyvi* 

In saying thus much, my object has been to settle the 
signification of these words, by comparing them with their 
original acceptation — a standard that ought never to be lost 
sight of in the application of such terms, so long as the 
same terms are technically retained : otherwise there 
would be no end to the confusion introduced by the right 
which every author might claim of defining them according 
to his own individual conceptions : of this we have fresh in- 
stances every day, there being hardly two authors who use 
these terms in precisely the same sense. 



44 EVIDENCE OF THE CONTAGIOUS 



infected by communicating with the first case 
in Valetta, — and to the Augustin Convent. 

III. And its extension to certain of the 
Casals, — -and to the island of Gozo. 

The evidence will, in each of these in- 
stances of comunication, be made out by direct 
proofs, excepting in the first, which, for want of 
facts derived from satisfactory authority, to 
establish fully an * actual communication be- 
tween the San Nicolo and the City, I design 
to prove by a different method ; but I be- 
lieve this item of the evidence will be borne 
out by circumstances as convincing as any 
which have yet been brought forward, either 
directly or indirectly, to determine the con- 
tagious quality of the disorder. 

The considerations tow Inch I attach parti- 
cular importance, as pointing out the San 
Nicolo, the fons et origo malorum, are to be 

* The manner in which the Plague was introduced into 
Valetta from, this vessel, was confidently stated in Malta to 
have been by a piece of linen, part of her cargo, which was 
purchased by one Salvatore Borg, a shoemaker, whose fa- 
mily was the first infected. 



NATURE 



OF THE PLAGUE, 



45 



found in an official letter, which I had the 
honour of addressing to the Commander of 
the Forces a few days after the arrival of this 
vessel in Malta *, and of which I here pre- 
sent a copy. 

Valetta, April 10, 1813. 

Sir, 

Although in offering the following observ- 
ations relative to the means of preserving this 
Garrison from the calamitous distemper with 
which it is threatened, I should not be alto- 
gether able to elude a charge of intrusion 
upon the province of the Health Officer, yet, 
as the only Physician to His Majesty's Forces 
on this station, I trust your Excellency may 
be pleased to see that the contribution of my 
opinion at such a juncture, (though it has 

* It may be satisfactory to the reader to be informed of 
the following particulars relating to the arrival of the San 
Nicolo : 

Two Turkey merchants shipped on board this vessel, at 
the Port of Alexandria, a cargo of linen* tlax, and leather, 



46 EVIDENCE OF THE CONTAGIOUS 



not been called for,) is not unjustifiably at 
variance with my duty. It was my intention 
to have had the honor of addressing your 
Excellency on this subject some time ago, 
and previous to the malady being reported 
so close in our vicinity. The melancholy fate 
of* the surrounding countries which have 
lately fallen a prey to its ravages, left in my 

with some other articles. Part of the crew having 
died of the Plague on their voyage to Malta, the 
vessel applied to the Health Department of the Island on 
her arrival (the 28th March) for admittance into Port, pre- 
viously using the precaution to notify her state, by hoisting 
a yellow flag with a black ball in the centre, this being the 
signal to indicate the actual existence of Plague on board. 
Her application being acceded to, she was accordingly re- 
ceived into quarantine in the Marsamuchet Harbour, within 
about a cable's length of several points of land and of the city 
of Valetta. The surviving part of the crew were taken into 
the Lazaretto, situated in a small island in the middle of the 
harbour. The captain of the San Nicolo and his servant 
sickened in a day or two after their being received into the 
Lazaretto, and died with indisputable symptoms of the 
Plague. 

* At this time, and for a year previous, the Plague was 
raging with violence in differents pails of the Levant. 



NATURE OF THE PLAGUE. 4/ 



mind no doubt as to the expediency of such 
a proceeding. My purpose was, however, 
for the present overruled by certain of my 
friends, who could not be brought to believe, 
that the evil was in the least likely to ap- 
proach so near to ourselves. If credit can 
be placed in the report of the day, these ex- 
pectations have proved delusive, and, there- 
fore, I can no longer apprehend that my 
addressing your Excellency on this subject 
should be deemed improper. I shall, con- 
sequently, hasten to submit for your consi- 
deration a proposal, from which, obvious as 
it certainly is, I am led to think considerable 
advantage might * still be derived for the pro- 
tection of Malta against the introduction of 
Plague. With this view I would suggest, 
that neither the harbour of Marsamuchet, nor 
the Island there, usually allotted to quaran- 
tine should, upon the present emergency, be 

* The word still is used here in consequence of my having 
understood, at the time of writing this letter, that an appli- 
cation to destroy the infected vessel then lying in Marsa- 
muchet Harbour, was resisted. 



48 EVIDENCE OF THE CONTAGIOUS 



accessible to any arrivals from suspected 
Ports ; and, therefore, that some more dis- 
tant, yet commodious place, be sought out, 
which, after being insulated from all inter- 
course with the inhabitants, should exclu- 
sively be destined for the reception of all 
vessels with any * suspicion of the disease. 

Some information which I have lately re- 
ceived, will not allow me to doubt, Sir, that 
•f* such a place may be found, and that the 
vessels, cargoes, and crews of infected ships 
could be disposed of in such a secure manner 
as to allow of the least possible risk. Unless 
called upon, I will not trouble your Excel- 

* From the arrival of the San Nicolo, until she was sent 
away nearly a fortnight afterwards, vessels continued to be 
received into this harbour from the infected Port of Alex- 
andria, some of which had the Plague on board ; and, 
among others, a Gibraltar Xebec privateer, and two trans- 
ports, the Monarch, and Intrepid. 

Vide Giornale di Malta. 

t Vide p. 8, for Briarley's and Lawson's Reports of St, 
Paul's Bay, the harbour here alluded to. 



NATURE OF THE 



PLAGUE. 



49 



lency with any detail of particulars by which 
my proposal might be carried into effect. 

Whether the apprehensions now prevalent 
about the existence of Plague in our vicinity 
be sufficiently founded or otherwise, I can- 
not resist conviction, that the measure I have 
been proposing would, in time of such peril, 
have been at the first, (that is, when the 
San Nicolo applied for admittance,) of much 
importance. Assuming that there exists no 
longer any reason to doubt, that the disease 
has actually made its appearance in the 
neighbouiing quarantine ground, the dangers 
arising from the extreme proximity of that si- 
tuation to so very populous a neighbourhood as 
this, are, in my humble judgment, too obvious 
to require comment, since the points of invasion, 
by so formidable an enemy, are thereby so 
fearfully multiplied. How awfully has the 
experience of other times informed us, that in 
this and in similar situations of exposure, the 
Plague finds its way in defiance of the most 
vigilant regulations ! 

H 



50 EVIDENCE OF THE CONTAGIOUS 



It is this reflection which has chiefly pre- 
vailed with me to submit the above pro- 
position to your Excellency, by the prompt 
adoption of which it appears to me the best 
chance would be afforded of checking the 
approaches of a calamity which, even a little 
delay, might baffle the best efforts to oppose. 

I hope 5 Sir, the urgency of the occasion 
will atone for any imperfections in this letter, 
attendant upon haste and anxiety, and that 
you will believe me, with the most zealous 
concern for the interests of His Majesty's 
Army, and the people here committed to 
your Government, 

Your Excellency's, &c. 

Arthur Brooke Faulkner, 

Physician to 
His Majesty's Forces. 



To Lieut. -General Oakes, 
Commander oj the Forces, 
Sfc. Sfc. $)-c. 



NATURE OF THE PLAGUE. 



51 



Can any one who gives a cool and impar- 
tial consideration to the contents of this 
letter, and bears in mind, at the same time, 
that the Plague had not visited the people of 
Malta for upwards of one hundred and thirty- 
seven years, hesitate a moment to conclude 
that the presence of the San Nicolo, and 
the Plague, which manifested itself in Va- 
letta in four or five days after this warning, 
do not stand to each other in the relation of 
cause and effect ? This, I confess, appears to 
me, as a learned authority* observes, one of 
those " consecutions which are so intimately 
and evidently connexed to, or found in, the 
premises, that the conclusion is attained, quasi 
per saltum, and without any thing of ra- 
tiocinative process, even as the eye sees its 
object immediately and without any previous 
discourse ■fy' 

* Hale on the Origin of Mankind. 

f The inference I have here drawn from the above letter 
is, indeed, so intuitively obvious, that T am apt to doubt, 
whether any attempt to render it more so, would not, as in 
the case of axiomatical truth, rather tend to tarnish its clear- 



52 EVIDENCE OP THE CONTAGIOUS 



To allege, in the face of the above letter, 
that the breaking out of the Plague in Malta, 
on the arrival of the infected vessel, was 
a fortuitous coincidence, and no otherwise 

ness. If>therefore, the following remarks,which are merely de- 
signed to place the circumstances of the case in a more familiar 
point of view, and to meet some of the most plausible objec- 
tions which have been taken against it, should be deemed 
supererogatory by the majority of readers, I shall hope that 
my motives for obtruding them, will atone for the trespass, 
and that these observations will not be considered as arising 
from any idea in my own mind, that the subject stands the 
least in need of support beyond the contemplation of the 
facts of the case itself. To take a parallel instance with the 
one under consideration, let it be supposed that a person is 
chargeable with having intimated that a murder would be 
committed in his neighbourhood within a very short time, 
although no such event had happened there for nearly 
a century and a half, and that, in exact agreement with this 
intimation, the murder was actually perpetrated in the 
course of three or four days, would not every credit be due 
to this person for the particularity of h's knowledge re- 
specting the agent of the crime ? At least, would not any 
Court of Justice be warranted in regarding the evidence as 
abundantly sufficient to justify his apprehension, in order to 
obtain an account of the circumstances which brought him 
acquainted with the fact; and, in the event of his refusing 
to give such information, can it be doubted that his life or 
his libeity would not be in danger from the operation of 



t 



NATURE OF THE PLAGUE. 53 

connected with the presence of that vessel, 
appears to me, I own, hardly less rational, 
than, were the same reasoning employed to 
maintain, that an explosion taking place at 

the laws? [f this be a just way of putting the case, the same 
kind of evidence must be equally deserving of credit, as ap- 
plied to my warning, relative to the impending sufferings of 
Malta, and becomes not less conclusive in establishing the 
correctness of my knowledge of the agent which was to in- 
flict them. In both cases, the accomplishment following in 
exact conformity with the prediction, infers equally an ac- 
quaintance with the cause concerned in producing it. 

The same general principle which would have warranted 
me in anticipating the diffusion of the Small-Pox, or any 
other contagious disease, under the same circumstances as the 
Plague on board the San Nicolo, as fully justified the warn- 
ing contained in my letter to the Commander of the Forces ; 
namely, the obvious connexion which the universal expe- 
rience of mankind has established between certain natural 
phenomena as they occur in the regular and immutable re- 
lation of antecedents and consequents. It is needless to 
add, that it is upon this connexion the w hole skill and success 
of every natural and empyrical science depends, and, that the 
Physician is enabled, not only to form his opinion as to what 
effects will follow from the presence of certain morbific 
agents, but by exploring effects with no less certainty to in- 
fer the agent or cause from which they are derived, although 
he may for ever be unable to give any satisfactory account 



54 EVIDENCE OF THE CONTAGIOUS 



the time of applying fire to gunpowder, 
was not the proper consequence of its ap- 
plication thereto, but a mere contingency 
happening at the moment of the contact. The 
only difference in the two cases is this, that, 
in respect to the fire, the effect is more con- 
stant and immediate, than in reference to the 
Plague -Ship, but, in either case, as the event 
could be predicted by our experience, it is 
entitled to be looked upon as equally and 
indissolubly connected with its peculiar cause. 
The want of constancy in the succession of 
causes and effects, although it be the source 

of the bond of connexion subsisting between these pheno- 
mena and their respective signs or indications. It is thus, 
also, that men are enabled to anticipate the most common 
events of life, 

Hinc tempestates dubio praediscere coelo 

Possumus : hinc messisque diem, tempusque serendi. 

****** 

Atque haec ut certis possimus, discere signis, 
JEstusque, pluviasque, et agentes frigora ventos ; 
Ipse Pater statuit, quid menstrua Luna moneret, 
Quo signo caderent Austri, quod saspe videntes 
AgricolaCj propius stabulis armenta tenerent. 



NATURE OF THE 



PLAGUE. 



55 



of much scepticism, and has led many to 
deny their connexion altogether, is, in re- 
ality, no argument to justify such negation. 
For, let us recollect, that even those causes 
which are deemed the most constant in nature, 
may, at certain times, fail of being followed by 
their effects ; and, as fire itself will not exert 
its action upon a combustible substance, 
unless under circumstances favourable to its 
agency, so neither will the contagious poison 
of Plague infect a person exposed to it, 
unless he be in a condition to be influenced 
by its power. In a word, both fire and con- 
tagion are equally proved, by our experience, 
to be specific and immutable causes, but only 
differing in degree as to the circumstances 
which render each of them operative *. The 

* Aristotle remarks upon the same indissoluble connexion 
subsisting between natural agents and their effects, whether 
these effects proceed of necessity, or in the usual way of their 
occurrence. " A thing," says he, " is originated by Nature, 
(or, in other words, is produced by a natural cause,) when it 
contains within it the principle of its production, which must 
also observe a certain order. It matters not, whether the 



56 EVIDENCE OF THE CONTAGIOUS 



same remark will hold good throughout the 
whole realm of Nature ; and there, is, per- 
haps, not a single cause in the chain of her 
operations that is not subject to the same va- 
riation, in reference to the constancy of the 
effect. But as this matter will be pursued in 
a more proper place, I will pass it over at 

present without further consideration. 

The unexpected termination of the first 

case that occurred in Valetta, and which, as 
will be seen by the description hereafter 
given, was marked by decidedly pestilential 
symptoms — the rapid and successive attacks 
and deaths of those only who had imme- 
diate intercourse with this case, and who had 
all similar symptoms, and such, moreover, 
as characterized the disease imported in the 
San Nicolo — the immunity of the Island 
from a disease so distinguished for a hundred 
and thirty-seven years — the almost univer- 

occurrence of the thing be of necessity or in compliance with 
what has been usual, since it can only happen in one way, 
let that tcay be what it will" Quasi h oauv *jte clirlx sv otvrois 
mat TZTxyfAsyy* y»p stsi % us stwtoXv uaxvrus »VoCa/>s<. 



NATURE OF THE PLAGUE. 



57 



sally-acknowledged fact, that no other cause 
can produce the Plague but the presence of 
the diseased subject, or some substance im- 
bued with pestilential poison, — when all these 
considerations are coupled with the actual 
presence and exposed situation of the San 
Nicolo, and viewed in connexion with each 
other, the proof is rendered, in my judgment, 
as complete as the question can require, that 
this vessel was the immediate cause of the 
contamination of the Island, whether we 
should ever be enabled to trace the mischief 
to a communication with the vessel, or other- 
wise: and the evidence acquires additional sup- 
port from a circumstance, which was universally 
acknowledged at the time the Plague made 
its appearance, namely, that there existed no 
grounds, either demonstrable,probable, or even 
plausible, with regard to the climate, or cir- 
cumstances of the Island, in any one respect, 
that could account for a deviation from the 
usually favourable state of the public health. 
Thus, whether we reason from the effect to 
the cause, or vice versa, we find the San 
Nicolo and the Plague of Malta connected as 

i 



58 EVIDENCE OF THE CONTAGIOUS 

signs of one another, and this is all the know- 
ledge we shall, probably, ever arrive at on 
the subject of causation. It is, however, 
abundantly sufficient for every purpose of 
regulating our practice, such physical con- 
nexion constituting the whole amount of what 
we denominate experience.— — But I will desist 
from any attempt to elucidate this matter far- 
th er, believing that it has little required the time 
here bestowed upon it for this purpose. — 
I cannot help again observing that nothing 
but a wish to meet every probable objection 
on the point in consideration, (and, I may 
add, that even the striking evidence of the 
facts has not been sufficient to prevent such 
objections from being urged), could have 
compelled me to make so great, and, it ap- 
pears to me, so unnecessary a demand on 
the patience of my reader. If these reason- 
ings should have failed to make the thing 
clearer, and I do not require to be con- 
vinced that the contrary may be the case, it 
only supplies a new instance to shew that no 
propositions are so difficult to prove as those 
which are nearly self-evident. 



NATURE OF THE PLAGUE. 59 

That there were serious reasons for the 
panic occasioned by the admittance of the 
Plague-ship, besides the insidious and ma- 
lignant character of the disease itself, will, 
probably, not be denied, when it is known, 
that the guardians employed to watch over 
the vessel were taken from the very lowest 
of the community, and paid for their labour 
only about one shilling and sixpence or two 
shillings per day — a pittance which, in Malta, 
was hardly equal to a bare existence. The 
risk arising from the employment of these 
persons, on an occasion of such peculiar and 
imminent peril, will further appear when we 
come to make some remarks on the quaran- 
tine and police system. 

After all the foregoing particulars are 
duly considered, it surely will not seem 
surprising, that the inhabitants of Valetta 
should have been seriously alarmed for their 
safety ; and, in melancholy conformity with 
their worst apprehensions, the Plague broke 
out nearly in the heart of the city, within 
a few days after the arrival of the vessel. 



60 EVIDENCE OF THE CONTAGIOUS 

The first person attacked was the daughter 
of Salvatore Borg, the shoemaker, of whom 
mention has already been made, and who 
resided near the centre of* strada St. Paulo, 
one of the principal streets of Valetta. 

Since the foregoing matter was pre- 
pared for the press, I find, on perusing a very 
able letter published last year by Dr. Granville, 
that the account of the introduction of the 
contagion into Valetta from the San Nicolo, by 
apiece of linen, has received a full confirmation 
under the authority of Sir Thomas Maitland's 
dispatches, and other official papers. If any 
farther circumstances besides what have been 
stated could be required to establish the 
pestiferous communication between the San 
Nicolo and Valetta, this so well authenticated 
a fact must render the evidence altogether 
conclusive. — See Dr. Granville's letter to the 
Right Hon. F. Robinson, M. P. &c. &c. p. 01, 

* See the map of Valetta, letter E, 



NATURE OF THE 



PLAGUE. 



61 



SEC. II. 

I now proceed to shew how the Plague 
extended through the different members of 
Borg's family, and from thence to such in- 
dividuals as had communication with this 
family, in the chain of their successive 
attacks. 

In a circular and official letter, issued on 
the 4th of May, 1813, it is stated, that on 
the 16th of the preceding month, a girl, one 
of Salvatore Borg's children, (the person 
above mentioned, as the first attacked in 
Valetta,) is taken ill with symptoms of fever. 
She was visited by a Maltese physician on 
the 19th, who found her in a dying state, 
from what he considered to be typhus. The 
child died on the same evening. During 
the visit, he observed on her chest, below 



62 EVIDENCE OF THE CONTAGIOUS 



the mammae two tumors *, which resembled 
carbuncles; but knowing the parents to be 
extremely subject to cutaneous diseases, he 
paid no more attention to them. The mo- 
ther of this child, in the seventh month of 
her pregnancy, was taken ill on the 1st of 
May with an attack of fever, and complain- 
ing of a tumor in the groin, which gave her 
uneasiness. The physician examined the 
part, and found the upper glands of one 
groin enlarged, although not much in- 
flamed. On the 3d, the woman miscarried 
and the infant soon afterwards perished. In 
the course of the day, she complained of pain 

* According to the report published in the Government 
Journal of Malta, the circumference of these tumors was 
not inflamed. They had a flat crust of a rosy colour on the 
top, la loro Sommita era velata da un escara piana e di- 
colore rossiccio. How, with so many collateral circum- 
tances to justify the strongest suspicion, any Physician 
could have hesitated to pronounce a case so characterized as 
this to be Plague, seems unaccountable ; and yet, we shall 
presently see, that the Maltese Faculty did not issue their 
decided opinion to the Public on the real character of the 
disorder, until much irretrievable time was lost. 



NATURE OF THE PLAGUE. 63 

in the other groin, but lower down than on 
the opposite side, which was also examined, 
and found in an incipient state of inflam- 
mation. She died during the night without 
delirium, or any expectation on the part of 
the Physician that the event would be fatal. 

On the 4th her husband, Salvatore Borg, 
was attacked with fever, having, at the same 
time, an enlargement of the glands of the 
axillae, and likewise in the groin : This man 
continued to linger until the 12th of the 
month, when he died with unequivocal 
symptoms of Plague. 

Maria Agius, a school mistress, who was a 
frequent visitor in Borg's family, and who 
assisted his wife during her accouchment, 
was next assailed. This woman died on the 
6th. After her decease, the body was con- 
veyed to the Maltese Hospital for examina- 
tion; and it was ascertained, beyond any 
doubt, that she was taken off by the 
Plague, exhibiting, among other unquestion- 
able marks of the disease, a large tumor in 
one of the axillae. 



64 EVIDENCE OF THE CONTAGIOUS 



On the 8th Grazia Pisani was removed to 
the Lazaretto, affected with febrile symptoms. 
On the loth a bubo made its appearance : 
on the 16th it burst, and she became 
convalescent. This girl used to live on 
terms of the closest intimacy with Maria 
Agius, and was in the frequent custom of 
passing the night at her house until after 
Agius became infected. 

On the 8th, Salvatore Borg's father is 
seized with symptoms of a suspicious kind, 
and died the day following. 

On the 14th, another child of Salvatore 
Borg's, about two years old, is taken ill, 
affected with fever, accompanied with a car- 
buncle near the os sacrum. On the 15th a 
bubo appears in his right groin. After having 
given some promising signs of recovery, the 
child at length perished. 

On the l?th, Arcangelo Delicata, after 
a residence of eleven days in observa- 
tion, on account of communicating with 
Maria Agius, was seized with equally well 
marked symptoms, having a carbuncle near 



NATURE OF THE PLAGUE. 



65 



the os sacrum, of a gangrenous aspect, and 
being, at the same time, affected with fever, 
pain of the head, and vomiting. He died 
the same day. This man was a near re- 
lative of Agius, and was accustomed to visit 
her constantly, both before and after her 
attack. Here, then, we have traced the pro- 
pagation of the disease from the first case in 
Valetta, in eight distinct and well authenti- 
cated instances, and all of them in the conti- 
nuous line of communication with each other. 
The last six cases are given on the authority 
of Medical reports, published under the 
sanction of the Government of Malta. 

About this time the contagion began to 
diverge in so many directions, in conse- 
quence of the unrestrained intercourse of the 
people, that it would have been extremely 
difficult, if not impracticable, to follow up 
the direct line of contaminations, even if the 
investigation had been earnestly pursued, 
which I have reason to believe was not the 
fact. Indeed, unless possessed of a more 
than ordinary share of ardor in the cause, it 

K 



66 EVIDENCE OF THE CONTAGIOUS 

was little likely that any one should set about 
the undertaking with the necessary perse- 
verance, at a momen t when so great terror and 
dismay paralysed the public mind. Besides 
there were but a few individuals who could 
command all the requisite facilities for con- 
ducting such an investigation with any good 
hope of success ; and those persons being pub- 
lic functionaries, were in general so unremit- 
tingly occupied in other duties, as to have, 
probably, as little time as inclination for 
entering upon a task of such peculiar danger 
and difficulty. 

In the above cited instances, the contagion 
has been traced in a direct line a month 
and twenty days subsequent to the first en- 
trance of the San Nicolo, and above a month 
after B org's first infected child was taken ill 
in Valetta ; added to which, it is proved by 
official statements, that up to this period, 
there were no other individuals, excepting 
those already detailed, infected in any part 
of Malta. The document in support of this, 
to which I immediately allude, is contained in 



NATURE OF THE PLAGUE. 



67 



an official report of the 15th of May, and 
runs in the following terms II rapporto 
medico civile, militare, e di marina, fatto in 
questo giornale, e stato favorevole per non essere 
accaduto alcun caso in tutta la popolazione, chi 
merita essere rimarcato" Let us pause on 
these details, and I think they will bring home 
conviction not to be resisted by any unpre- 
judiced mind, that no other cause than con- 
tagion can possibly explain why the Plague 
should have been for so great a length of time 
confined to so few individuals, and to those 
individuals exclusively who had immediate 
communication with each other. 

I next pursue the progress of the disease 
into the Augustin Convent. 

The promiscuous intercourse which was 
kept up, especially among the lower order 
of people, for so many weeks after the 
Plague was introduced into Valetta, renders 
the task of tracing it into private or public 
buildings almost impracticable ; and, to add 
to the difficulty, it will ; be easily believed, 
that their infected inhabitants, either from 



68 EVIDENCE OF THE CONTAGIOUS 

a dread of the Lazaretto, (that bourne from 
which so few returned,) or from an appre- 
hension of punishment, should their illness 
have been the consequence of any wilful 
violation of the police laws, or public orders, 
would be little disposed to make volun- 
tary confession of their state, or of the 
source from which the infection was received. 
With regard to the Augustin Convent, the 
matter was otherwise; and the cause of its 
contamination is proved by circumstances, 
and supported by authority, alike decisive 
and unquestionable. This convent, situated 
in a peculiarly healthful, spacious, and 
airy part of Valetta, had, from the very 
beginning, observed the greatest caution to 
shun communication with the public. It 
was at length, however, infected in conse- 
quence of one of the servants, who was ca- 
terer by occupation, having, in disobe- 
dience of public orders, gone into a very 
contaminated part of the town, called 
the Manderaggio, and purchased infected 
clothes. Shortly after his return he made 
full confession of the circumstance, when 



NATURE OF THE PLAGUE. 69 



one of the brotherhood belonging to this 
convent, out of compassion, immediately 
volunteered to attend him, placing himself, 
at the same time, in strict quarantine with 
the patient. Both nurse and patient imme- 
diately fell victims to the disease, but no 
other individual under the same roof was ever 
assailed. These things are altogether noto- 
rious, and were circumstantially related to 
me by a priest of the monastery, one of the 
most respectable inhabitants of Valetta, who 
rendered great service to our Government 
by his activity and vigilance as a superin- 
tendent of the district in which he was em- 
ployed to watch over the state of the public 
health. Judging from the advantages in so 
many respects enjoyed by the Augustin Con- 
vent in point of situation, standing not far 
from the top of one of the main streets, and 
much above the level of the sea, and the 
greater part of the city ; the cleanliness and 
openness of the neighbourhood ; the spa- 
ciousness of the interior accommodations, 
and the respectability and good order of its 



70 EVIDENCE OE THE CONTAGIOUS 

inmates, it was, perhaps, the very last place 
where ingenuity could discover a pretext to 
explain the production of the disease through 
the agency of any other than a contagious 
cause. The escape of every other person 
within its precincts, excepting the servant 
and his attendant, with both of whom care 
had been taken that every possible communi- 
cation should be cut off from the moment the 
matter transpired, puts the thing, in my 
opinion, beyond any reasonable doubt. 

It may be asked, is it not probable that 
the servant would have infected some other 
person under the same roof with him be- 
fore the disease fully manifested itself ; to 
which I answer, it was possible, but by no 
means necessary. Many circumstances may 
be imagined to account for the immunity 
of the rest of the inhabitants of the con- 
vent ; for example, this may have been one 
of those cases, where but a very short space of 
time elapsed from the pestiferous contact, and 
that, in consequence, the disease had not 
yet arrived at that stage when it acquires 



NATURE OF THE PLAGUE. 71 



the power of communicating infection in 
any considerable degree. It may also have 
happened, that until the servant found him- 
self indisposed, he had had in reality no 
communication by contact with any one in 
the convent, or, being conscious of having 
purchased infected articles, he may have 
become, of his own accord, cautious of 
holding any intercourse with those around 
him, before he made confession of the deed, 
and put them on their guard. But, however 
the thing is to be accounted for, there cer- 
tainly is no absolute reason to conclude that 
the rest of the society must have been con- 
taminated as a matter of necessity. This 
subject will be considered more fully, when 
I come to speak of the various degrees of 
susceptibility possessed by different indivi- 
duals exposed to contagion, and of the many 
concurring circumstanes which may be neces- 
sary to render contact actually effective in 
producing the disease. 

In farther proof of the protection conferred 



72 EVIDENCE OF THE CONTAGIOUS 

by seclusion, an historian * of the former 
Plague, which visited Malta in 1675, ob- 
serves that all public buildings which cauti- 
ously shunned intercourse with the commu- 
nity, enjoyed a perfect exemption from the 
contagion, among which were the prisons, 
monasteries, and the cavalieri, or inn, occu- 
pied by the Knights of the Order, besides all 
the vessels in the harbour. And in the late 
Plague, the Hospital of Saint John of Jeru- 
salem, the prison, and several public offices 
and private houses, which early adopted, and 
steadily kept up, a rigid system of insulation, 
were not less fortunate. 



SEC. II L 

The introduction of the Plague into the 
casals, or inland towns and villages, could 
be traced in a direct line, not less satisfac- 



* Cavallino. 



NATURE OF THE PLAGUE. 73 



torily than in the instances already recited, to 
certain individuals, who were either infected 
themselves, or who had held some kind 
of intercourse with persons labouring under 
the disease. 

The authenticity of this part of the evi-. 
dence is guaranteed by written documents, 
which were put into my hands by one of the 
Captains of the Port of Malta, a very old 
and intelligent officer of the Health Depart- 
ment, the nature of whose services afforded 
him peculiar facilities of procuring informa- 
tion on the subject of pestilential contagion, 
and whose duties during the Plague, fur- 
nished him with ample opportunities of 
making the necessary enquiries relating to 
the mode and circumstances of its diffusion, 
especially through that part of the Island 
which was placed more immediately under 
his superintendence. It is this officer's opi- 
nion, that wherever the Plague makes its 
appearance, and proper measures are strictly 
enforced, sur le champ , its progress may be 
completely arrested, not only within the limits 

L 



74* EVIDENCE OF THE CONTAGIOUS 

of the infected families, but may be prevented 
from extending even beyond the individual 
attacked in the very first instance, provided 
he be instantly removed out of the reach 
of communicating with others, and that the 
susceptible articles with which he has been 
in contact, undergo a thorough expurgation. 
The truth of this has been repeatedly exem- 
plified during the late sufferings of Malta, the 
disease being arrested at once in several of 
the casals, in the houses originally contami- 
nated, by the immediate adoption of rigorous 
and prompt measures of separation and se- 
clusion, under the direction of the ma- 
gistrates. In other casals, where these mea 
sures were either delayed, or were not so 
decidedly acted upon, the Plague spread to 
an alarming extent. 

As the officer to whom I have alluded 
gives a very circumstantial account of the 
manner in which several of the casals had the 
disease brought into them in the direct line 
of contact, I think I cannot do better than 
to follow him throughout his detail from the 



KATURE OF THE PLAGUE. 75 

beginning, making only a few corrections in 
the phraselogy, as he was not very con- 
versant with our language. There is also some 
irrelevant matter, for which the author is not 
strictly responsible, as I am satisfied the do- 
cument was never expressly designed for 
publication. I will, however, take as few 
liberties with the manuscript as is necessary 
to avoid being obscure. 

" Facts and repeated experience," says 
this officer, " clearly shew, that whenever 
the Plague makes its appearanee, and prompt 
measures of precaution are taken, instead of 
public functionaries fighting for dominion, 
losing days, weeks, and months, in mere 
discussions and intrigues, sacrificing innocent 
lives, and disgusting those whose intentions 
are really good, it may not only be arrested 
in the house originally contaminated, but will 
even sink in the first case, though occurring 
in the midst of a family, provided the remain- 
ing individuals are removed out of the house, 
and that they depurate themselves and their 
effects. 



76 EVIDENCE OF THE CONTAGIOUS 



" The first case of Plague occurred in 
Valetta. The subject of it was the daughter 
of one Salvatore Borg, who fell sick on the 
* 14th of April, 1813 ; but the character of 
the complaint not be suspected, there was 
no meeting of Medical Authorities to ascer- 
tain it until the 4th of May. Thus, notwith- 
standing that twenty-two days had elapsed, 
during which time all Borg's family were in 
habits of free communication with the inha- 
bitants of Valetta, no contamination could 
elsewhere be traced ; and had the necessary 
precautions been listened to and adopted, 
the malady would not have proceeded be- 
yond those who were already assailed. In- 
deed, the progress of the disease, even until 
June, was so slow, that in twenty or thirty 
days, by the retreat of the inhabitants to their 
houses, and by affording assistance to the 
poor, it might have been exterminated without 

* Although this date varies from the official report which 
I have copied above, by a reference to the Government 
Journal of Malta, it appears quite correct. 



NATURE 



OF THE 



PLAGUE. 



77 



farther trouble. From what has been stated, 
and from the facts which will come presently 
to be mentioned, any one must be convinced 
that the Plague is not a disease of that dread- 
fully rapid progress, and destructive nature 
that is generally supposed. The communi- 
cation between the country and Valetta 
being freely open, several casals, in conse- 
quence, became contaminated. But after a 
proper plan of precautions was recommended 
to the lugotenenti) or magistrates, the. conta- 
gion received an immediate check, and from 
casal Bircarcara to casal Mosta, including 
not less than twenty thousand souls, this plan 
of precaution was followed by the happiest 
effect, with the single exception of Bircarcara, 
where the spirit of party triumphed over all 
considerations of the public safety. 

" Casal Lia, from about the 5th to the 12th 
of June, was placed in the most alarming 
situation, in consequence of having the 
Plague communicated to it by two different 
introductions. The first took place through 
the medium of a family of the name of Per- 



78 



EVIDENCE OF THE CONTAGIOUS 



cius, consisting of eight individuals, who, 
leaving their habitation in Strada Pozzi, a 
much infected street in Valetta, took up 
their residence in this casal. 

" The second case occurred in the family 
of one Taria, consisting of six perons, and 
was occasioned by a boy who came home 
infected with the disease, which he caught 
whilst employed in the corn magazines at 
Floriana. Three individuals of the former 
eight, and two of the second six, perished. 
One of the former, and two of the second, 
recovered. 

" The resume of this casal is as follows : 
Inhabitants of the casal. . . • 1800 
Introductions of Plague . • • • 2 

Houses infected 2 

Inhabitants of these houses 14 

Died 5 

Cured 3 

Propagation 0 

" Casal Atard had likewise two distinct and 
separate attacks of Plague, from the 22d of 
May until the 3d of July. The first was 



NATURE OF THE PLAGUE. 



79 



occasioned by one Paola Borg, who con- 
ducted her daughter from Valetta into this 
casal, whilst labouring under the disease. 
The second introduction took place through 
one Lorenzo Fenech, who was infected by 
communicating with persons in the neigh- 
bourhood of Casal Zebbug. 

" The resume of casal Atard is as follows : 
Inhabitants of the casal, . . • 1000 
Introductions of Plague .... 2 

Houses infected 2 

Inhabitants of these houses 7 

Died 2 

Propagation 0 

" Casals Mosta and Nasciar deserve no less 
credit for their promptness in stopping the 
contagion, having had the disease brought 
into each of them five several times, and as 
many times suppressed. 

" In Casal Mosta the first case took place 
in the month of June, the disease being in- 
troduced by a farmer of the name of Paolo 
Sant, who possessed a field near St. Paul's 
Bay, where he had been for some time 



80 EVIDENCE OF THE CONTAGIOUS 



resident, though his proper dwelling was in 
the casal. This man was accustomed to gain 
a livelihood by carrying the produce of this 
little farm for sale into Valetta, where, it is 
probable, he received the infection. As soon 
as he became indisposed, he was immedi- 
ately conducted by his wife and one of his 
sons to his house in Casal Mosta. 

" The second attack occurred in the month 
of July, and was occasioned by a person at- 
tempting to rob the house of a beccamorto, 
or grave digger, who had died of the Plague. 
When this man first discovered his illness, 
he was living with his family, consisting of 
four individuals. 

" The third and fourth cases fell out in Au- 
gust and September in the families of two 
persons of the name of Magro and Demarco, 
ten in number ; but the cause of their con- 
tamination remains unknown. 

" The fifth introduction happened, like- 
wise, in the month of September, and 
was owing to one Grazia Zammit, wife to a 
beccamorto, employed at a casal, called 



NATURE OF THE PLAGUE. 



81 



Rabato, having gone thither to see her hus- 
band, whilst he was engaged in his perilous 
duties. At the time of her being taken ill, 
she was occupying her fathers house, with 
six other persons. It is satisfactory to know, 
that during these five introductions of the 
Plague into Casal Mosta,the deaths amounted 
only to one and twenty, including four bec- 
camorti and two guardians, out of a po- 
pulation of nearly four thousand ; and that the 
contagion, without being propagated farther, 
was stayed in the houses originally infected. 

" Caterina Manueliwas the person who first 
imported the disease into Casal Nasciar. This 
occurrence took place early in June and, was 
occasioned by her bringing home some 
clothes to be washed belonging to her son, 
one of the forzati, or convicts employed in 
Valetta to carry the sick and the dead out of 
infected houses. The family of Manueli 
comprised in all five individuals. 

" This casal was infected in the second 
instance by one Joseph Frendo, a labourer 
employed at Floriana, whilst the Plague was 
raging there with great violence. 

M 



82 EVIDENCE OF THE CONTAGIOUS 

" The third house contaminated in casai 
Nasciar was that of Signor Michel Vasallo, a 
lugotenente, who had his wife and daughter 
living with him. He was infected by hand- 
ling papers which were received without un- 
dergoing fumigation. 

" The fourth introduction of the disease was 
occasioned by one Maria Schembri, who had 
had communication with her daughter at 
Bircarcara whilst suffering under the disease. 

" The fifth introduction occurred in the 
month of September* in the family of Grazia 
Galea, consisting of six persons. As the 
malady at this time began to decline very 
rapidly, this event appeared the more unac- 
countable. It was supposed to have arisen 
from her husband having had intercourse 
with a certain cattle-dealer, who was in 
the practice of frequenting an infected place 
called Saint George's Tower. From the 
house of Grazia Galea the disease was carried 

* Nasciar was contaminated again in December by com- 
munication with a house near St. George's Tower; but the 
contagion was arrested in a few days, without spreading 

farther. 



NATURE OF THE PLAGUE. 



83 



to that of one Pietro Mula, a relative of hers, 
who had a large family ; but happily the 
contagion was arrested as promptly in this as 
in any of the former instances. 



The resume of Casal Nasciar is as follows : 


Inhabitants of the casal .... 


2800 


Introductions of Plague 


5 




6 


Inhabitants of these houses 


26 




10 




5 




1 



" Out of more than twenty thousand persons 
occupying the line of casals from Bircarcara 
to Mosta, not above five hundred in all were 
taken off by Plague ; and of these by far the 
greater number in Bircarcara, in consequence 
of the spirit of insubordination which dis- 
graced that place, and which completely de- 
feated the precautions attempted to be put 
in force by the Police Department. Bircar- 
cara was besides much more populous than 



84 EVIDENCE OF THE CONTAGIOUS 



any of the other towns mentioned. Yet even 
in this casal, as soon as adequate measures 
began to be enforced, the mischief was al- 
most immediately put a stop to. 

" Several additional instances might be 
cited to the same effect ; Casals Zeitun, 
Tarxien, Gudia, Micabiba, and others, fur- 
nishing equally clear and indubitable evi- 
dence as in any of the foregoing cases, that 
energetic measures will always be attended 
in like circumstances with equally happy re- 
sults. 

In conclusion, the Plague was introduced 
into the Island of Gozo by a man belonging 
to casal Curmi, several of whose family had 
died of the disease. It rests upon respect- 
able testimony, that this person, previous to 
his removal into quarantine, found means to 
conceal a box, containing wearing apparel, in 
the cottage where he resided ; and that at the 
expiration of his quarantine he re-entered his 
cottage *, out of which he took the box, and, 

* It was currently represented, that this cottage was, at 
the time of concealing the box, included within a cordon ot 



NATURE OF THE PLAGUE. 



85 



after paying a visit to *Valetta, hired a boat, 
and transported it to Gozo-f [Here end 
the statements of the Captain of the Port.] 

When the whole of the preceding details 
are summed up, and considered m connexion 
with the authority upon which they rest, few, 
I believe, who are not under the influence of 
a strong bias, would hesitate to admit that 
the Plague is, in the strictest sense of the 
term, a contagious disease, since it has been 
made out, that contact with an infected me- 

troops which invested the town ; but the troops being shortly 
afterwards drawn closer to the casal, the cottage was, in 
consequence, left in the rear, which afforded an easy op- 
portunity of re-entering it, and taking out any susceptible 
article without exciting suspicion. 

* This event happened about the 8th of March ; and Va- 
letta had obtained clean bills of health on the 14th of 
January. 

f It is farther stated, that this man made a present of the 
clothes as a marriage gift to one of his family residing in this 
island, who were immediately afterwards attacked by 
Plague, and were the first persons infected. Whether the 
above account of the box be strictly authentic or not, it is 
certain that the Plague broke out immediately in this family 
after the arrival of their relative. 



86 EVIDENCE OF THE CONTAGIOUS 

dium, had, ipso facto, preceded its propaga- 
tion, in every instance where the sources of 
contamination could be investigated; and 
the weight of evidence is further augmented 
when we reflect that not one solitary well 
attested example can be adduced of any in- 
dividual being attacked, where the proofs 
were absolutely conclusive that some kind of 
contact, direct or indirect, was not known, 
or might not be strongly suspected to have 
gone before the seizure. Were the reverse 
of this the true state of the matter, it is ob- 
vious, that instead of finding it difficult to 
discover such instances, they must have been 
incomparably more frequent than those 
which could be traced to contagion. 




fill 



:u ZabLar 



* 1q --3 Tarjden 



aola 



Zeitim 



si Guasciac 



X 



. «■ T ,u 1 




i 

Chercop 



: MLc&Hba 



Zxirich 



:? Crendj 



/ 



5^ 



NATURE OF THE PLAGUE. 



87 



CHAPTER IV. 

SEC. I. 

Farther Evidence in proof of the contagious property of the 
Plague, drawn from the extent of contamination in each 
of the Casals, as influenced by their locality— by their dis- 
tance, in respect to the principal sources of infection— - and 
other circumstances. 

The main error into which most of those 
writers have been betrayed, who, whilst de- 
nying the contagious character of the Plague, 
ascribe its production to the state of the at- 
mosphere, seems to me to hinge upon their 
assuming as the generating cause, what is 
properly only a predisposing or concurring 
cause. 



88 EVIDENCE OF THE CONTAGIOUS 



Their notion of its atmospheric origin pro- 
ceeds chiefly from the disease being observed 
frequently to arise and spread at particular 
seasons of the year ; and the hypothesis is 
considered to receive farther support from the 
fact, that other diseases which are allowed 
to be manifestly not contagious, are most 
prevalent under a peculiar state of the air, 
and occur, generally, at the same seasons as 
the Plague. Thus, from the apparent agree- 
ment of these diseases in this one point, of 
arising usually at the same time of the year, 
aided, perhaps, by some accidental or ima- 
ginary similitude in certain of their fea- 
tures, it becomes, at length, assumed as a 
demonstrated truth, that they are all of the 
same class, differing only in the modification, 
or severity of the symptoms ; and, accordingly, 
arguments are pressed into the service in as 
great number as ingenuity can rake together, 
for the purpose of propping up the assump- 
tion. Should the instances which have al- 
ready been presented prove insufficient to 
shew how incommensurately this atmospheric 



NATURE OF THE PLAGUE. 



89 



doctrine accounts for the production of the 
late Plague in Malta, I fear nothing which I 
can add would be likely to place the matter 
in a clearer light. Such, however, as coin- 
cide with me in the cogency of the preceding 
statements, will probably discover in those 
which follow, still farther grounds for ex- 
cluding a peculiar state or constitution of the 
air as the productive source of Plague. I 
accordingly pursue my proofs by noting the 
extent of mortality in all the principal towns 
and villages * of Malta, accompanying the 
statement, as far as my documents will al- 
low, with an account of the situation, soil, 
and other circumstances, of each, that it 
may be seen how far the vitiation of the 
atmosphere, by local causes, is entitled to 
be regarded as the generative source of the 
disease in those places. The deaths are car- 
ried up only to the 15th of October, about 
which period the violence of the malady was 
nearly spent. 

* The following account of the situation and circumstances 
of the different easals may appear rather minute and tedious; 

N 



90 EVIDENCE OF THE CONTAGIOUS 

I much regret my inability to furnish 
farther documents besides those already pro- 
duced, with reference to the particular modes 
by which the contagion was introduced into 
each of the remaining casals. Indeed, with 
the exceptions already noticed, I never had 
any means of coming at the authorities from 
which such information could be authenti- 
cally obtained ; and I am unwilling to ad- 
vance any thing that is not derived from 
competent testimony. 

The twenty-four principal casals of Malta 
may be comprised under the three divisions 
of eastern, central, and western, formed by 
drawing a right line from Valetta, making an 
angle of rather better than sixty degrees with 
the main road, communicating between that 
place and Citta Vecchia, which is the second 
principal city of Malta. 

but it seems to be of importance, as favoring the view which 
the foregoing facts present, with regard to the contagious 
spread of the disease ; and by the full statement I also ob- 
viate any unfavourable inference which might be drawn from 
a partial detail. 



NATURE OF THE PLAGUE. 91 



The eastern casals lie out of the direct 
road of communication with Valetta, and are 
twelve in number viz. 

Gudia 

Luca 

Zeitun 

Zabbar 

Chercop 

Zurich 

Tarxien 

Paola 

Sasi 

Guasciac 

Micabiba 

Crendi 

The central division lies in the very direct 
line of intercourse with Valetta, and includes 
six casals, viz. 

Curmi 

Zebbug 

Siggeui 

Dingkli 

Atard 

Rabato 



92 EVIDENCE OF THE CONTAGIOUS 



The western division is not so much out of 
the line of communication with Valetta as 
the eastern, some of the casals which it com- 
prises being, in fact, equally close to the 
direct high road fiom that city, as those in 
the central division. The western casals are 
six in number, viz. 

Bircarcara 
Lia 

Nasciar 
Mosta 
Gargul 
Balzan 

The circumstances of each of these casals 
shall be considered individually in the order 
of their enumeration ; and, first, of casal 
Gudia. This town- occupies an open situation 
to the eastward of Valetta, the name signi- 
fying in the Maltese language. " high 
ground." It possesses the advantage of a 
dry soil, in as great a degree as any other 
part of Malta. Yet Gudia * was the first 



* See the Government Journal of Malta, 



NATURE OF THE PLAGUE. 



93 



casal in which a death by Plague was re- 
ported to have taken place. This event hap- 
pened about the 18th of May, when three 
persons died — in June two, and in July 
one; after which the contagion was arrested. 
Casal Gudia is distant * a little more than 
three miles from Valetta, and three quarters 
of a mile from casal Luca, which was shortly 
afterwards much contaminated. 

Casal Luca lost the first case by Plague 
on the 25th of May — in June, twenty-two — 
in July, seventeen, and one only in August, 
when the disease was subdued. It is nearly 
two miles and a half from Valetta, and not 
quite a mile and a half from Curmi, which 
was afterwards one of the most severely vi- 
sited towns. Casal Luca stands also upon 
high ground. 

In Zeitun, a place of rather large extent, 
the contagion appeared about the 27th of 

* The distances from Valetta, and between the casals, are 
calculated in a straight line, and not according to the mea- 
surement of the roads, which I had no opportunity of ob- 
taining- 



94 EVIDENCE OF THE CONTAGIOUS 



May, during which month only one person 
perished — in June four, and in July, six, 
when it was finally arrested. This town is 
about two miles and an half from Valetta, 
and a mile from Zabbar, a casal which was 
visited with some severity soon afterwards. 
Zeitun lay much out of the road of direct 
communication with Valetta, and likewise 
occupies an elevated position. 

At Zabbar the Plague made its appear- 
ance about the 30th of May, when only one 
person was carried off — in June, six — in 
July, twenty-eight, and in August, nine, 
—after which the disease was suppressed. 
Zabbar, occupying a high spot about a 
mile and an half from Valetta, lay nearer, 
and had greater intercourse with the towns 
within the fortifications, than any other casal 
in this division of the island. 

Chercop lost one solitary case only, on 
the 4th of June. It is about three miles and 
an half from Valetta, and not quite one mile 
from casals Luca and Gudia respectively. It 
is also not much more than a quarter of a 



NATURE OF THE PLAGUE. 



95 



mile from casal Sasi, which will afterwards 
be noticed as having, with a few others, en- 
tirely escaped contamination. It stands 
equally on an eminence as Sasi, from which 
it is separated by a short distance of low 
ground. 

Zurich, a casal of considerable magnitude, 
was visited by Plague on two different occa- 
sions ; the first about the 17th of June, in 
which month five persons died. The second 
attack took place in July. It lies not more 
than a quarter of a mile from Sasi, about 
four miles and an half from Valetta, and 
three quarters of a mile from casal Micabiba, 
which will presently be noticed as slightly con- 
taminated. The air of Zurich is accounted 
by the natives to be particularly healthful, 
standing partly on the same elevation as Sasi, 
and partly declining into low ground 

Tarxien, a town of moderate extent, was 
not assailed until the latter end of the 
month of July, when only one individual was 
carried off by Plague, and the casal was never 
afterwards infected. Tarxien, placed on an 



96 



EVIDENCE OF THE CONTAGIOUS 



eminence, lies about a mile and something 
better than three quarters, from Valetta ; ra- 
ther less than half a mile from Paola, and not 
quite a mile from Zeitun. It deserves to be 
particularly remarked, in respect to this casal, 
and casal Paola, that they had only a few 
solitary cases ; a circumstance the more ex- 
traordinary, as Paola, to which it is so con- 
tiguous, was long known to be, without ex- 
ception, the most unhealthful spot in Malta, 
being situated in the vicinity of wet ground, 
formed by the tide, running up where the shore 
is flat. Yet, at Paola, only two cases of 
Plague occurred ; the first not until the 26th 
of July, and the last in August. The distance 
of Paola from Valetta is nearly a mile. 

Casal Sasi, as already noticed, escaped 
the infection. It is about four miles and an 
half from Valetta, and less than a mile from 
Micabiba. Some have alleged, that Sasi, 
on account of the great purity of its air, en- 
joyed a peculiar exemption from the pre- 
vailing contagion. But, in reality, this opi- 
nion is, in a great measure, gratuitous, there 



NATURE OF THE PLAGUE. 97 

being no reason, deducible either from its si- 
tuation, soil, or any local peculiarity, to jus- 
tify the supposition, that this village was fa* 
vored by purer air than many other places 
which suffered severely. Besides, the closely 
adjacent infected towns possessed advan- 
tages in an equal degree as Sasi, in regard 
to the soil, and, every thing conducive to 
their salubrity. If it be true, that Sasi 
escaped solely on account of the peculiar 
purity of its air, how shall we be able to 
account for the entire escape of four other 
casals, and particularly of casal Crendi, 
which we shall presently see had some ob- 
vious disadvantages to encounter. Can we 
•suppose that the air of these four other 
casals which escaped as well as Sasi, during 
the late Plague, was more pure at that time 
than in the Plague of 1675, when every casal 
in Malta was contaminated, with the solitary 
exception of Sasi ? It may not be out of 
place to revert to the remarks which have 
already been made respecting casals Paola 

o 



98 EVIDENCE OF THE CONTAGIOUS 



and Tarxien, as farther supporting the 
opinion, that impure air of itself is insuffi- 
cient to produce Plague ; for, if this were the 
case, we have had the indubitable evidence 
of local causes for concluding that these 
places must have been among the most con- 
taminated spots in the island ; the reverse of 
which was the fact. 

Guasciac happened, likewise, to be one of 
the fortunate few that entirely escaped the 
general visitation. It is not altogether three 
miles distant from Valetta, nor above half a 
mile from casals Tarxien, Zeitun, and Gudia, 
respectively. 

Micabiba lost five cases by the disease 
in the month of June, and one only in July, 
when the mischief was suppressed. It is 
about four miles from Valetta, a little more 
than two miles from Curmi, a mile and a 
quarter from Luca, and a mile and three 
quarters from Zebbug. 

Casal Crendi, the skirts of which occupy 
rather low ground, was another of the fa- 
voured few r w hich were preserved in uninter- 



NATURE 



OF THE 



PLAGUE. 



99 



rupted health, though situated not more 
than half a mile from its contaminated neigh- 
bours, Micabiba and Zurich. It is, however, 
well ascertained with regard to casal Crendi, 
that from the very first alarm of the Plague, 
the inhabitants conceived such a dread of in- 
fection, as determined them to exclude, of 
their own accord, all strangers from coming 
within their walls. Had this caution not been 
taken with so much promptness and deter- 
mination, it is very probable this casal would 
have been not less unfortunate than most 
others, since, besides possessing no ad- 
vantages in point of soil or situation, the 
houses were rather of a meaner construction 
than ordinary, and were inhabited by a very 
poor class of people. 

In conclusion, I may observe that these 
eastern casals occupy the lowest and flattest 
quarter of Malta, the greater numberof them 
being situated towards the north-east point of 
the island, which may be considered as the 
lowest edge of an inclined plane, having its 
highest elevation on the S . S. W. side, where 



100 



EVIDENCE OF THE CONTAGIOUS 



it rises nearly two hundred fathoms above 
the level of the sea. The low and flat sur- 
face of the eastern division, renders it less 
inconvenient for cultivation ; for which reason 
it contains double the number of casals in 
proportion to the number of acres. 

The first casal in the central division is 
Curmi. This place, lying in low ground, 
was one of the greatest sufferers in the island. 
It became contaminated about the 24th of 
May, in which month two persons perished 
— in June, fifty- six — in July, one hundred 
and nine — in August, one hundred and forty- 
two— in September, one hundred and eighty- 
one — and in October, up to the fifteenth of 
the month, fifty. Curmi is said by the 
Maltese to derive its application from its 
vicinity to Valetta, from which it lies about 
two miles, and is nearer to it than any other 
casal on the direct road from that city, and, 
consequently, more exposed to communica- 
tion with Valetta, than any other casal in 
Malta. It is placed directly between Zeb- 
bug and Valetta, from the former of which 



NATURE OF THE PLAGUE. 101 



it is about a mile and a quarter distant, 
nearly the same distance from Luca, and not 
much beyond half a mile from Bircarcara, 
which will presently be noticed as one of the 
most desolated casals ; so that Curmi was 
exposed not only by its contiguity and tho- 
roughfare with the chief source of contami- 
nation, Valetta, but likewise by its prox- 
imity to three other casals, which were 
most peculiarly marked out for devastation, 
in the very centre of which it is situated. 
I was informed by the Inspector General of 
Police, whose indefatigable exertions and 
ability in putting a stop to this frightful ca- 
lamity, entitle him to the highest praise, 
that the great mortality in Curmi proceeded 
from the want of proper restrictive measures 
imposed at the beginning, and this opinion 
was fully borne out by the results of his own 
system of Police ; for, from the moment that 
that system was put into full operation under 
his personal direction, and that due obedience 
was secured by military authority, the com- 
munication being completely intercepted be- 



102 EVIDENCE OF THE CONTAGIOUS 



tween Curmi and Valetta, and from the 
other casals, by a cordon of troops investing 
the town on all quarters, the disease yielded 
with rapidity. The decisive measures adopted 
at Curmi so very speedily accomplished their 
object, as to induce the Inspector General to 
think his presence no longer required, and 
that he might withdraw his personal super- 
intendence without detriment to this casal in 
behalf of another, where the disease was 
spreading rapid desolation. He was, how- 
ever, obliged very speedily to retrace his 
steps to Curmi, the contagion having, as it 
were, rekindled during his absence ; but 
which, on his return, was checked with the 
same expedition as before, by the enforce- 
ment of the same measures *. 

The low situation of Curmi may suggest 
the idea of its being damp, and therefore 
particularly exposed to pestiferous miasms, 

* This casal continued to have cases for a great length of 
time, owing to two causes — the pilfering, and the conceal- 
ment of infected articles. — See Government Gazette of Malta. 



NATURE OF THE PLAGUE. 103 



but if this be admitted, we shall be reduced 
to the difficulty of shewing why the Plague 
had not commenced its ravages here in the 
first place ; instead of which this town was 
not infected until a month and three weeks 
after the importation of the disease, and five 
weeks after the contamination of Valetta. 
But the allegation is set at rest by a consi- 
deration of the circumstances of Zebbug, the 
next casal which claims our notice. 

Casal Zebbug had the Plague imported 
about the 26th of May, when two persons 
died — twenty-five in June — one hundred and 
thirty-eight in July — two hundred and 
seventy in August — two hundred and thirty 
two in September — and seven in October, 
up to the loth of that month. This place, 
though so frightfully ravaged, is situated on 
the ridge of a hill, which extends several 
hundred fathoms from North to South. The 
soil is perfectly dry, as might be expected 
from its elevation ; and, in short, it is as free 
as any place can be imagined from any kind 
of local impurity, Yet here the disease made 



104 EVIDENCE OF THE CONTAGIOUS 



its most unsparing havoc. Zebbug lies about 
four miles on the main road from Valetta, 
and a mile and a quarter from Curmi,* so 
that, if the expression may be allowed, it 
lay not less on the high road of contagion 
than Curmi itself. 

The disease did not reach casal Siggeui 
earlier than the 11th of September, in. which 
month eight persons perished ; and only one 
other case occurred up to the 15th of October. 
This casal is about three quarters of a mile 
from Zebbug. We have the authority of the 
Captain of the Port for stating, that the 
contagion was arrested in this town by prompt 
separation, the burning of susceptible goods, 
and the immediate and effectual purification 
of houses ; and in a memorandum which I 
kept of some of the infected towns, I find, 
likewise, that the Inspector General of 
Police had noticed to me the suppression 
of the disease in Siggeui, as a remarkable 
instance, to shew how completely the con- 
tagion is subject to the power of restrictive 
measures, not one case having occurred there 



NATURE OF THE PLAGUE, 105 



after his orders were carried into effect. This 
casal is situated in a valley which branches 
into three directions, and is a place of only 
moderate extent. The distance from Valetta 
is about four miles and an half. 

Dingkli, a comparatively small casal, was 
not assailed until the 8th of October, when 
but one individual perished. This is the 
most southern casal in Malta, partly occu- 
pying a valley, about a mile and three 
quarters from Rabato, the nearest contami- 
nated town, and not less than eight miles 
from Valetta. 

* Casal Atard had the Plague introduced 
about the 22d of May, during which month 
there occurred only one death by Plague; the 

* In respect to this and some of the succeeding casals, 
the deaths are already noted in the statements of the Captain 
of the Port, so that their recapitulation in this place may 
appear superfluous. I have, however, considered this ob- 
jection more than counterbalanced by the greater uniformity 
given to the narrative; as well as by the opportunity afforded 
to the reader of comparing with that officer's details these 
additional extracts taken from the official reports of the 
Health Department. 

P 



106 EVIDENCE OF THE CONTAGIOUS 



next death happened in July, when the infection 
was completely eradicated. This town lies 
about three miles and an half from Valetta, 
better than half a mile from casals Balzan 
and Lia, and not much above a mile from 
casals Curmi and Zebbug. That this place 
was not visited more severely might, there- 
fore, reasonably excite surprise, had we not 
so good authority as that above cited, for 
knowing that the extermination of the dis- 
ease was accomplished by the prompt pre- 
cautions which were adopted by its inha- 
bitants in limine ; and, perhaps, a more 
decided instance could not possibly be ad- 
duced to prove that the malady is under 
control of early cautionary measures than the 
good fortune of this casal presents. For, in 
no respect was casal Atard favoured by any 
advantages, actual or supposable, in point 
of air, soil, or situation, above either of 
its afflicted neighbours, Curmi or Zebbug, 
the close adjacency of which, but for these 
measures, must have exposed it to a peculiar 
devastation. The confines of casal Atard lie 



NATURE OF THE PLAGUE. 10? 



in low ground, skirting the same valley in 
which part of Curmi is situated. 

The Plague commenced in Rabato about 
the 21st of May,* when only one indi- 
vidual was its victim. The next two deaths 
occurred in June — -nine in July — six in Au- 
gust — ten in September — and five in Oc- 
tober, up to the 15th of the month. Rabato 
was not surpassed in any part of Malta, not 
even by Valetta itself, in point of dryness of 
soil. It is distant about six miles from Va- 
letta, with which it communicates by the 
great main road, and not altogether two 
from the lamentably desolated casal 
Zebbug. 

Here closes the list of central casals, 
which, we have seen, were ravaged in a 
degree exceeding any of the former, and this, 
notwithstanding that several of them occu- 
pied situations at a greater distance from Va- 
letta, than most of those which are included 
in the eastern division. I infer, therefore, 
that their disasters must have sprung not so 
much from their contiguity to Valetta, as 



108 EVIDENCE OF THE CONTAGIOUS 



from their being situated on the direct road, 
and in the line of immediate thoroughfare 
with that city and other infected places. 

The first town to be note*d on the western di- 
vision is Bircarcara. At this place the Plague 
manifested itself about the 2d of June, in the 
course of which month twenty-five persons 
were carried off— in July, fifty-seven — in 
August, eighty-nine — in September, seventy- 
four — and in October, up to the fifteenth of 
the month, twelve persons. Bircarcara, as 
already stated, was very populous, the houses, 
however, in general, large and commodious. 
There were no circumstances attaching to the 
soil of Bircarcara, although it occupies a 
valley, that could, by the most strained hy- 
pothesis, explain why it should have been 
visited by Plague. On the contrary, its 
standing upon a nearly naked limestone 
rock, must have conferred, if any thing 
could, a total exemption from every kind of 
noxious exhalation ; in evidence of which I 
may remark, the word Bircarcara in Maltese 
signifies lime-pits. The fate of this town is 



NATURE OF THE PLAGUE. 



109 



folly explained, when we take into account 
the spirit of insubordination which has been 
mentioned as prevailing there for so long a 
time, and its contiguity and direct commu- 
nication with Valetta and casal Curmi, from 
the former of which it is about two miles 
distant, and not more than half a mile from 
the latter. 

In casal Lia the Plague made its first ap- 
pearance about the fifth of June, during 
which month only five persons died, the 
infection being suddenly extinguished by 
the vigorous exertions of the Police. This 
town lies in low ground, about three miles 
and three quarters from Valetta, half a 
mile from Nasciar and about one from Bir- 
carcara. Here again we have proof equally 
strong as in the instance of casal Atard, of 
what efficacy a coercive system of health 
is productive — for, in fact, casal Lia was as 
much exposed both from situation and con- 
tiguity to infected sources, as that place or 
any other which has been noticed. 

Casal Nasciar, situated on an eminence, 



110 EVIDENCE OF THE CONTAGIOUS 



and commanding a view over a great part or 
the country, was invaded by Plague about 
the 11th of June, in the course of which 
month five persons died — in July, two— and 
in September, I think not more than three. 
Nasciar lies nearly a mile and a quarter be- 
yond Bircarcara, and three miles and three 
quarters from Valetta. 

Casal Mosta, occupying a rising ground 
about four miles and an half on the direct line 
from Valetta, was infected about the 12th of 
June, when one person died— in July, nine 
—in August, fifteen— and in September, 
eight*. The disease was then suppressed 
by the prompt separation and removal of the 
sick and infected, the burning of their sus- 
ceptible goods, and the whitewashing and 
expurgation of their houses. This casal is 
the most distant in the western division. The 
nearest towns are casals Lia and Nasciar, 

* It appears in the statement of the Captain of the Port, 
that there is a difference of twelve in the number of deaths 
when compared with this, which may have arisen from his 
not believing some of the cases to be Plague. 



NATURE OF THE PLAGUE. Ill 



from each of which it lies a little better than 
half a mile. The soil and situation are alike 
favourable to the health of the inhabitants. 

To Gargul and Balzan, the last two prin- 
cipal casals in Malta, the infection never ex- 
tended, owing, as we have already been in- 
formed, to the strict and unrelaxing caution 
which their inhabitants observed to prevent 
any intercourse with their infected neigh- 
bours. Neither of these places possessed 
any peculiar advantages, either from soil or 
position. The good fortune of Gargul may, 
however, partly have been owing to its being 
the most remote town to the West, and lying- 
out of the line of any direct communication 
with Valetta, or, with any other contami- 
nated place in its vicinity, with the single ex- 
ception of Nasciar. It also occupies a rising 
ground. Balzan is almost a continuation of 
casal Lia, lying in the same valley between 
*it and Bircarcara, and, consequently, from 
its contiguity to the latter, was the more in- 
debted for its security to the active measures 
which have been noticed. 

Gozo was not contaminated until about the 



112 EVIDENCE OF THE CONTAGIOUS 

8th of March, 1814. From what has been 
said of the soil and cultivation of this little 
island, I should think it very needless to take 
pains in shewing that it enjoys every possible 
exemption from any of the known, or even 
suspected causes of atmospheric impurity. 
It is moreover separated from Malta by a 
distance of three miles and three quarters of 
sea. I am not enabled to annex a statement 
of the number of deaths in Gozo, having left 
Malta before the disease had ceased to per- 
vade that island. But it rests upon the most 
satisfactory authority, that owing to the 
energetic measures which were followed up, it 
lost, comparatively, but very few in propor- 
tion to the population : I think, in all, not 
above eighty. 

That the relative mortality of the casals 
in each of the three divisions may be seen at 
a first view, they are here presented in a 
tabular form, with their respective dates of 
contamination, and in the order of their 
successive attacks, as extracted from the 
official reports, published by order of the 
government of Malta. 



NATURE OF THE 



PLAGUE. 



113 



Casals. 



> 

s 



Gudia 

Luca 

Zeitun 

Zabbar 

Chercop 

Zurich 

Micabiba 

Tarxien 

Paola 

Crendi 

Sasi 

Guasciac 



Rabato 

Curmi 

Atard 

Zebbug 

Siggeui 

Dingkli 



Bircarcara 
Lia 

Nasciar 
Mosta 
Gargul 
Balzan 



Dates of 
Contamination 



May 18 

23 

.24 

30 

*. 4 

7 

June ••••• 1 
Julv 21 

• • 25 

• • • • 6 s • 

May 20 

• • • 22 

• • . • .... . . 22 

26 

September 11 
October 8 



Deaths to the 
15th October 

6 

41 

11 

44 

8 

6 

1 

2 

• <" ~ " •••••• 

Total, 119 

33 

530 

2 

675 

9 

1 

Total, 1250 



May 28 

June. ..... 6 

23 

July... 8 



252 

5 

10 

33 



Total, 300 



It is difficult to ascertain the exact day on which tlie contamination of 
each of these casals took place. I am pretty sare, however, tbat few of 
the dates, here stated, vary above one day, from the most autheutic reports, 

Q 



114 



EVIDENCE OF THE CONTAGIOUS 



SEC. II. 



From the particulars which have been just 
brought to view, we observe with how little 
respect to air, soil, or situation, the Plague 
carried its desolating triumph through every 
part of Malta. If we look at the casals, in 
reference to their respective distances from 
the common source of contamination, Va- 
letta, and from the towns most infected in 
their neighbourhood, we shall find, just as we 
ought to expect during the prevalence of a 
contagious disease, that, in general, the de- 
gree of severity with which each suffered, 
was in the ratio of its degree of communica- 
tion with those sources of infection ; or, to 
use a more definite and precise mode of ex- 
pression, in the ratio compounded of its di- 
rect communication with, and vicinity to 5 



NATURE OF THE PLAGUE. 



115 



Valetta, and the adjacent infected towns. 
Thus it has been shewn, that casals Curmi, 
Bircafcara, and Zebbug, situated not far 
from each other, and on the direct and most 
frequented high road from Valetta, were de- 
populated to an extent far exceeding any of 
the rest. Mosta, Rabato, Luca, and Zabbar, 
were next in order the greatest sufferers ; Mos- 
ta lying on the direct high way from Valetta. 
and near to casals Lia and Nasciar. Rabato, 
within two miles of Zebbug, (the most in- 
fected of all the casals,) and likewise on the 
direct high way from Valetta ; and Luca, oc- 
cupying a situation in a right line, though not 
so immediately on the most frequented road 
from that city, and within a little better than 
a mile of casal Curmi, which was the second 
in order of the most depopulated towns. These 
casals were, consequently, not only in a par- 
ticular manner exposed to the common 
source of contamination by their lying in a 
direct road and perpetual thoroughfare with 
Valetta, but they must also have mutually 
contributed, by their contiguity to one ano- 



116 EVIDENCE 03? THE CONTAGIOUS 



ther, greatly to augment the number of 
pestiferous introductions in each. Gasal 
Zabbar being included in the eastern di- 
vision, and less exposed to communicate with 
Valetta than any of the towns or villages al- 
ready mentioned in the central division, as 
occupying the main road from that city, 
was, however, situated nearer to the towns 
within the fortifications than any of the other 
eastern casals ; and with these towns, it 
may be presumed, there existed a commu- 
nication, more or less free, until the Public 
became sufficiently aware of their danger, 
and the necessity of a cautious intercourse. 
Consequently, as Zabbar would be exposed 
to incur so much greater risk than any other 
eastern casal, of being contaminated from 
these towns, we find the fact entirely cor- 
responded with such a calculation. 

It may be thought that the escapes or slight 
contamination of the casals near to the coast, 
were owing to the greater purity of the air 
in those places. But that this was not the 
case is highly probable, from the fact that the 



NATURE OF THE PLAGUE. 117 



casals in the interior, as well as on the coast 
which were farthest removed from commu- 
nicating with Valetta, and other infected 
places, all experienced a much slighter visit- 
ation than any others, e. g. Gargul— 
Mosta — Dingkli — Crendi- — Zurich — Sasi — 
Siggeui — Micabiba — Guasciae, and Zeitun, 
the only apparent exceptions demanding no- 
tice, being Rabato and Mosta, the sufferings 
of which, notwithstanding their distance 
from Valetta, are to be accounted for by their 
lying on the direct road between that city 
and Citta Vecchia, which road is the great 
thoroughfare of the island, or, if the expres- 
sion may be admitted, the main artery of 
the circulating population. That the con- 
tiguity of the casals to the coast could not 
have availed, as conferring security from the 
contagion, we have already had evidence in the 
fate of Valetta, Floriana, and Zabbar. Gene- 
rally speaking, however, as the most distant 
places were the least exposed to intercourse, 
they were accordingly the least infected. 
Thus I have endeavoured to point out 



118 



EVIDENCE OF THE CONTAGIOUS 



the cause of the comparative degrees of se- 
verity with which the different casals were 
assailed ; and I believe, if all the circum- 
stances are well weighed, the evidence will 
appear abundantly conclusive, that the only 
satisfactory mode by which we can ade- 
quately explain the relative extent of their 
mortality, is their intercourse with contami- 
nated sources. But, when we reflect how 
much depended upon the activity of the 
Police, and the extent of voluntary obedience 
given by the inhabitants of each casal to the 
rules prescribed by the Health Department, it 
must appear unreasonable to look for a 
principle which should apply with any 
thing like exactness in accounting for their 
individual sufferings. Enough has, however^ 
been produced, to shew that the infection 
was not influenced in its progress through 
those towns, by the local causes of a vitiated 
atmosphere. 

It may be farther observed, that when to 
the distance of the respective casals from the 
sources of contamination, the advantage of 



NATURE OF THE PLAGUE. 119 



a thin population was superadded, the infec- 
tion became still less extensively disseminated; 
for instance, in casals Crendi, Sasi, Chercop, 
Dingkli, and Siggeui, each of which con- 
tained, comparatively, but a limited number 
of inhabitants : and in this way, we are enabled 
to explain why the infection should have 
been diffused more rapidly in Valetta than any 
where else, for, besides containing a much more 
numerous population, it is well known that the 
intercourse in that city was greatly promoted 
by the extensive connexions which resulted 
from commercial speculation. On the same 
grounds, it is easy to account for the greater 
difficulty which was experienced there, in 
arresting the progress of the contagion, than 
in most other places. I extract the following 
remarks from the Government Journal of 
Malta as expressive of the great alarm en- 
tertained on account of the general pre- 
valence of this commercial spirit in Valetta : 
— " Considerando una citta poco estesa, e 
sopracaricata da un' immensa popolazione, 
osservando lo spirit o d' industria de' suoi 



120 EVIDENCE OF THE CONTAGIOUS 



abitanti, che forza ogni contatto, guardando 
il vasto commercio, che vi si facea, ed il 
continuo trambusto di nazionali e di stranieri, 
e angustia di alcune strade, la ristrettezza 
delle case nelle quali sono gli uomini affas- 
tellati gli uni sopra gli altri, noi potevamo 
aspettarci di vedere in quest' isola maggiori 
devastazioni cagionarsi della peste/' 

The danger would, doubtless, have been 
much augmented by the avarice of those en- 
gaged in the work of expurgating houses, 
and burning susceptible articles, who were 
known~4o^ secrete and sell all such articles, 
whenever they could elude the vigilance of 
the Police— particularly wearing apparel. 



NATURE OF THE PLAGUE. 121 



CHAPTER V. 

Evidence continued, drawn from considerations which shew 
that an impure state of the atmosphere, is insufficient to 
account for the generation of the Plague. 

SEC. I. 

Of filth —crowding— and want of ventilation— as supposed 
causes of a pestiferous atmosphere. 

It has been observed, that casal Zebbug 
was ravaged to an extent far exceeding every 
other, though it is one of the most favored 
spots in point of locality, cleanliness, and 
ventilation, of any in Malta ; we have seen 
also, that casal Zurich did not escape con- 
tamination, though enjoying as many ad- 
vantages conducive to salubrity as either 
of its uncontaminated neighbours, Crendi or 
Sasi. To these examples, taken as they first 
present themselves, many, equally striking, 
might be added. Among a number of others 
which have not been noticed, I may annex the 

R 



122 EVIDENCE OF THE CONTAGIOUS 



following: — The Fourteenth Regiment and 
Artillery, quartered in one of the most in- 
fected parts of Valetta, and surrounded by a 
crowded neighbourhood, were preserved from 
the contagion throughout the whole period 
of the disease, by the early restrictions im- 
posed by their commanding officers, and an 
unrelaxing vigilance to interdict every kind 
of intercourse with the Public. De Rollers 
* regiment and the -f Third Garrison Batta- 
lion, were, however, infected, notwithstand- 
ing that they occupied, without exception, 
perhaps, the very highest and most health- 
ful situations in or about Valetta. 

It never was accounted for with absolute 
certainty, how the contagion found its way 
into these regiments ; but, in respect to De 
Rolle's, there is not much difficulty, at least 
in forming a satisfactory conjecture, as the 
mclosure near to the Barracks admitted of 

* De Rolle's was infected about the 25th June, 
f This battalion was attacked by the Plague, I think, about 
the 27th July, 



NATURE OF THE PLAGUE. 125 



a communication through its bars with the 
outside, suggesting a reasonable presumption, 
that some pestiferous article may have been 
received through this enclosure clandestinely, 
probably under cover of nig ht. 

The Sicilian regiment had the good for- 
tune of having only one person infected du- 
ring the whole period of the Plague, which 
was evidently the consequence of the vigi- 
lance of their commanding officer : that 
gentleman, whom we have already noticed 
in the capacity of Inspector-General of 
Police, as so active in arresting the conta- 
gion * : and, perhaps, no other instance could 
be selected to exhibit the benefit of early 
precautions in a more striking manner than 
the security enjoyed by this regiment, not- 
withstanding the peculiar exposure of its situ- 
ation, being quartered in the town of Flori- 
ana. which, for a longtime, was ravaged with 

* I have not been so fortunate as to discover the cause of 
the importation of the contagion into this regiment, It^ 
sudden extinction is among the clearest proofs of what proper 
means may effect under active and judicious superintendence. 



124 EVIDENCE OF THE CONTAGIOUS 



extreme severity, and, in a part of it, close 
to streets filled with pestilence, and remark- 
able for their crowding and every kind of 
nastiness. 

Those, who in the face of such facts, 
would still maintain that an impure atmos- 
phere was the exciting cause of Plague in 
these regiments, ought, at least, to be pre- 
pared to shew what grounds did actually 
exist for such an assumption. 

But, although I conceive myself justified 
to deduce from the above particulars, that 
local causes, independently of contagion, 
are insufficient to engender the Plague, it is 
by no means meant to advance that an im- 
pure atmosphere may not powerfully predis- 
pose to render pestilential contagion more 
active, or, in other words, more easily trans- 
mitted from one subject to another. Close- 
ness, crowding, and filth, we know, will 
greatly favor the progress and aggravate the 
malignity of other contagious diseases, and 
the most virulent of them, small-pox, for ex- 
ample, may be rendered innocuous at only a 



NATURE OF THE PLAGUE. 



325 



very short distance from the infected subject, 
by adopting simply the precaution of ventila- 
tion and cleanliness. Experience teaches us 
also, that fomites are much more ready to 
transmit contagion than the bodies of the sick 
themselves, but if these infected matters are 
exposed to the open air, they presently lose 
the power of communicating the disease, 
by the closest approximation, or even by 
contact itself. It is familiarly known to those 
engaged in the service of Fever Hospitals, 
that the porters employed to carry the sick 
are almost never assailed, nor even the wash- 
erwomen, whose daily office it is to cleanse 
the foul linen and bedding belonging to 
wards filled with the most malignant cases 
of typhus. As, therefore, the contagious power 
of typhus, and of small-pox, may acquire or 
lose force by the state of the air, as to pu- 
rity, it is not less probable that pestilential 
contagion is subject to similar modifications, 
and becomes either more virulent by uniting 
with foul air, or proportionately less so by 
dilution with air of a purer quality. How- 



126 EVIDENCE OF THE CONTAGIOUS 



ever the thing is to be accounted for, there 
certainly is no clear reason to forbid that 
a corrupted atmosphere may not give to pes- 
tiferous matter a greater activity, or render 
it more easily received into the human sys- 
tem. Should it be still maintained, how- 
ever, that local causes are of themselves fully 
and independently adequate to the produc- 
tion of Plague, it will be incumbent on those 
who support this opinion, to shew why the 
disease first broke out in the centre of one of 
the most spacious streets in Valetta, and was 
so long confined to one house in that street to 
the entire exclusion of those more crowded, 
narrow, and unventilated allies* which were 
the abodes of poverty and privation : Any 
local causes which could be presumed to 
operate in producing a pestiferous atmosphere 
in Strada St. Paolo, where the first case ap- 
peared, would, for instance, equally, if not 
much more virulently, be called into action 
in that part of the town called the Mander- 

* In my general description of Valetta, it escaped me to 
notice these allies.— They lie principally about the outskirts. 



NATURE OF THE PLAGUE. 



12? 



aggio *, which occupies one of the lowest and 
most confined situations, and includes a num- 
ber of lanes, so narrow, that their inhabitants 
might actually shake hands from the opposite 
sides, inclosing, moreover, within this limited 
compass, not less than two thousand persons 
of the meanest class : yet the Manderaggio 
was not infected until the 26th of May, a 
month and ten days after the contagion first 
entered the Island. — It is unlikely, too, that 
the Plague should have been confined to 
the one solitary house for so great a length 
of time after its introduction into Valetta, 
and not have been produced simultaneously, 
more or less, in every quarter of it, which 
was equally exposed to the operation of local 
causes. Besides, it may be asked, when the 
disease did break out in other houses, why 
it should have been in those which were dis- 
tinguished by no peculiarities in regard to 
atmospheric influence, but distinguished only 
by the circumstance of their inhabitants 



* See the Map, 



128 EVIDENCE OF THE CONTAGIOUS 



having been associates of the first infected 
family. 

Neither is it less inconsistent with proba- 
bility that Valetta should have been for so 
long a period the exclusive nidus of pestilence, 
seeing that there were villages and towns in 
the Island, where every tangible cause of 
local impurity existed in a still greater de- 
gree, and which places were known to be much 
more frequently unhealthful than this city. On 
the principle of local production, the same 
difficulties present themselves in accounting 
for the protracted escape of Floriana and 
other towns within the fortifications conti- 
guous to Valetta, the closeness and crowding 
of which were in many places not less ap- 
parent than in the most populous part of 
the Manderaggio. Yet, in one of these 
towns called Sanglea^, no decided case 
was discovered throughout the whole course 
of the malady. 

It has been said in explanation of some of 



* Vkk Malta Journal 



NATURE OF THE PLAGUE. 



129 



these difficulties, that the Plague does not 
always invade the most insalubrious places, 
but is carried from the first contaminated 
spot to others in the " course of the winds/' 
This, however, is only making a vague as- 
sumption to solve a difficulty. It is abun- 
dantly clear, from the order in which the 
casals were visited, that this opinion cannot 
for a moment be sustained, for instead of 
their being assailed in a direct line, which 
must be the case, were the winds the ve- 
hicle of the infecting matter, those casals 
suffered among the very first which were si- 
tuated at the most remote distances from 
each other, and in opposite directions. 
Moreover, if the air of an infected place 
could acquire a degree of virulence intense 
enough for its pestiferous power to be trans- 
ported to the length of some miles, it is ab- 
surd to suppose that the populous interme- 
diate towns should have entirely eluded 
its noxious influence, and, in fact, it is im- 
possible, going on such a supposition, that 
the malady should not have at once, more 
or less, indiscriminately visited the whole 



130 



EVIDENCE OF THE CONTAGIOUS 



of Malta, the confines of which are so very 
limited, and its towns so numerous and 
contiguous to each other *. Instead of this 
a month elapsed after the appearance of the 
first case in Valetta before any one in- 
habitant of the casals is reported to have 
fallen a victim to the disease ; and this first 
case occurred where ? in casal Gudia, a 
place, as before remarked, peculiarly un- 
likely to prove unhealthful by the operation 

* Had the disease arisen from the air, It is clear that 
neither shutting up nor separation could have been of more 
avail than if the same measures were resorted to for the sup- 
pression of intermittent or remittent fevers; and that in Malta, 
as well as in Walcheren or Gibraltar, the malady must have 
pervaded every place and every class of its inhabitants without 
discrimination. Of this fact, in reference to Walcheren, I am 
enabled to speak from experience, and if I could not, it is 
too well attested by the loss of one of the finest armies 
that ever left our shores, few of whom found any asylum 
from the climate, excepting by escaping from it altogether. 
Dr. Gardiner, naval Surgeon at Gibraltar, has declared, that 
in the epidemic which afflicted that place whilst the Plague 
was raging in Malta, " the disease did not spread from any 
focus, but broke out in fifty different places at once." The 
fact is farther attested by other most respectable witnesses, — 
Vide the works of Drs : Bancroft and Burnet. 



NATURE OF THE PLAGUE. 



131 



of any causes of a local description. On the 
local principle it is still farther at variance 
with reason and probability, that after the 
Plague had ceased in Valetta, it should con- 
tinue to ravage the interior ; and that when 
it had almost ceased in Malta altogether, it 
should have sprung up in Gozo after an in- 
terval of nearly twelve months from the first 
introduction of the disease into Malta. If 
the disorder could have depended for its 
production on a cause so unconfined in its 
application as the one in question, it is to 
me utterly inconceivable that such long pe- 
riods should have intervened between the 
dates of its appearance in each of these 
places. I find it also recorded of the Plague 
of 1675, that a considerable interval elapsed 
from the contamination of Valetta until that 
of Gozo. 

But farther : were the Plague generable 
by local causes, it would follow, that when 
Valetta was released from the malady, those 
causes must have ceased to possess the power 
of vitiating the atmosphere. It is universally 
known 5 however, that in Valetta the same 



132 EVIDENCE OF THE CONTAGIOUS 



manifest causes existed in a still greater de- 
gree for some time after the Plague was nearly 
suppressed, than previous to its appearance 
in that place, as from the want of the usual 
facilities, and the confusion that prevailed, 
there was more than the usual quantity of 
filth of every kind, collected in the habita- 
tions of the poor. If to this, it should be 
objected, that the general constitution of the 
atmosphere was such as to render local 
causes unoperative in Valetta when that city 
became healthy, it may be asked, how 
should such a favorable alteration in the 
general state of the atmosphere have been 
less fitted to produce the same salutary ef- 
fects in other parts of the island as well as 
Valetta, and more especially in those casals 
where the disease was never so severely felt, 
or which were, at least, equally exempt as 
this city from every thing fitted to occasion 
a vitiated atmosphere — for instance, in Ra- 
bat o 5 Bircarcara, and Nasciar, towns which 
continued to have cases for several weeks 
after Valetta was free from infection. 

If the general state or constitution of the 



NATURE OF THE PLAGUE. 133 

air became really such as to neutralize the 
pestiferous power of local causes in Valetta 
when the Plague disappeared there, how are 
we to account for those causes being roused 
into activity in Gozo — an island in all re- 
spects so favored with all the requisites of a 
healthy situation, and which had escaped 
the disease for so long a time. 

Should it be said that Rabato, Nasciar, 
Bircarcara, and Gozo, were each of them 
more liable to be contaminated than Valetta, 
in consequence of the soil extricating a great 
abundance of those pestiferous miasms, it 
may be again enquired, why were not those 
places visited in the first instance, instead of 
which no death by Plague is reported in 
Rabato for thirty-six days after Valetta 
was infected ; in Nasciar for thirty-nine 
days ; in Bircarcara for forty-four days ; 
or in Gozo for nearly eleven months after the 
announcement of the Plague in Valetta. 

Finally, as the period of a hundred and 
thirty seven years which elapsed since the 
former Plague of Malta must have produced 



134 EVIDENCE OF THE CONTAGIOUS 



a recurrence of every possible cycle of com- 
bination in regard to the elements of atmos- 
pheric impurity, does it not militate against 
every appearance of truth, that the disease 
should not have visited the island frequently 
during that long interval, and more parti- 
cularly at those periods when many powerful 
predisposing causes were acting upon the 
bodies of men calculated to increase their 
susceptibility of noxious atmospheric im- 
pressions. I allude to those times when the 
island was doomed to suffer severely from 
famine and siege, and more especially during 
the last siege, when from September 1799 
to the same month of the year following, not 
less than six hundred persons perished by 
the vile quality of their food, or by actual 
starvation *. 

* The garrison, on that occasion, were reduced for a con- 
siderable period of their sufferings to no better fare than the 
flesh of horses, asses, mules, cats, and rats ; and even this 
kind of subsistence most difficult to be procured. 



NATURE OF THE 



PLAGUE, 



133 



SEC. It. 

Of a " latent alteration in the state of the air," as a supposed 
pestiferous cause. 

Discovering the insufficiency of the fore- 
going causes, the advocates for atmospheric 
production have recourse to what is termed by 
Sydenham, a " latent and inexplicable alter- 
ation or occult influence in the state of the 
air, infecting the bodies of men," or what 
he expresses more succinctly, by a " pe- 
culiar constitution of the atmosphere/' Did 
not so many writers in the present day still 
insist upon the existence of this occult in- 
fluence, relying for support on the very im- 
posing authority of this justly celebrated 
author, I should not have considered it en- 
titled to a serious notice ; as the very men- 
tion of an occult cause shuts the door against 



136 



EVIDENCE OF THE CONTAGIOUS 



all kind of reasoning. But to shew with 
what difficulties the abettors of the hypo- 
thesis find themselves beset, even the great 
Sydenham himself is compelled to make the 
following acknowledgments : — " Though I 
have carefully observed the different con- 
stitutions of different years, as to the 
manifest qualities of the air, in order from 
them to discover the causes of the great dis- 
similitude of epidemic diseases, (among which 
he classes the Plague), yet I must own I 
have hitherto made no progress, having 
found that years perfectly agreeing as to the 
manifest temperature of the air have, never- 
theless, produced very different tribes of 
diseases/' In the next sentence, this author 
seems to abandon the latent quality of the 
air altogether, and to assign a specific and 
somewhat more intelligible account of its state. 
" There are various general constitutions of 
years that owe their origin neither to heat, 
cold, dryness, nor moisture, but rather de- 
pend upon a certain secret and inexplicable 
alteration in the bowels of the earth, whereby 



NATURE OF THE PLAGUE. 137 



the air becomes impregnated with such kind s 
of effluvia, as subject the human body to 
particular distempers, so long as that kind of 
constitution prevails, which, (he adds,) after 
a certain course of years, declines and gives 
way to another/' — This, however, is nothing 
more than adducing one gratuitous assumption 
to explain another. For do we, in point of 
fact, possess any evidence to determine, that 
any such alteration takes place in the bowels 
of the earth ? Its author, indeed, acknow- 
ledges that it is " a secret and inexplicable 
alteration/' by which he eludes all responsi- 
bility for its truth ; and we have no right to 
look for an explanation relative to a point 
which he is candid enough to allow will 
not admit of one. 

It would be foreign from the object of 
these pages to enter into any analysis of the 
reasonings of other writers who have contri- 
buted their various, and often very discre- 
pant opinions, on this subject; neither should 
I have considered it necessary to digress into 
this notice of Sydenham, but that such pe- 

T 



138 



EVIDENCE OF THE CONTAGIOUS 



culiar stress appeared to be laid upon the 
authority and infallibility of so eminent a 
physician by the learned Chairman of the 
Contagion Committee ; I will, therefore, 
trespass with only a few farther remarks on 
the reasonings of that writer, in reference to 
the subject before us, as they seem to me 
involved in even greater perplexity than 
those which have been stated. 

" That the air, (he observes,) obtains a 
secret disposition or temperature productive 
of different diseases at different times, will 
be apparent to such as shall only consider that 
the very same disease in one season proves 
epidemic and destroys great numbers, and in 
another seizes but few persons, without pro- 
ceeding farther, as is manifest in the small- 
pox, and more particularly in the Plague." 
Here I may remark, by the way, that in 
identifying the secret disposition of the air 
with its temperature, he considers tempera- 
ture in a totally different sense from its ac- 
ceptation in the present day, and means, in 
fact, no more or less that what in other 



NATURE OF THE PLAGUE. 



139 



places, he expresses by the " constitution" 
of the air. But how Sydenham could feel 
justified to infer, that because the same dis- 
ease in one season destroys greater numbers 
than in another, the air must, as a conse- 
quence, acquire a power of producing differ- 
ent diseases at different seasons, I confess I 
do not comprehend. It may be that I am 
not so happy as to perceive the force of the 
author's argument ; but as it is given in this 
passage, it appears to me absolutely unintel- 
ligible. Let us shape it in more general 
terms, and it will stand thus : Since a parti- 
cular cause is able to produce a more or less 
extensive effect, it must, for that reason, be 
also capable of producing effects which are 
dissimilar in their nature. With so manifest 
a want of connexion between the premises and 
conclusion, one may be justified, perhaps, in 
doubting that the author himself could have 
really meant to express himself so. Moreover, 
if a particular constitution of the air be "pro- 
ductive" of the Plague, it will follow that 
this constitution possesses an independent 



140 EVIDENCE OF THE CONTAGIOUS 



power of generating that disease, or the term 
productive would be misapplied, which, if I 
rightly understand its import, can only sig- 
nify such a power : but in the following 
passage we shall find that he refuses this 
power to the air, and at last calls in the 
agency of contagion to assist in the work of 
production — " But, besides the constitution 
of the air, or more general cause, another 
previous circumstance is required to produce 
the Plague, viz. the receiving the effluvia, or 
seminiiim, from an infected person, either 
immediately by contact, or mediately by 
pestilential matter conveyed from some other 
place. For when this happens in such a 
constitution as we have mentioned above, the 
whole air of that tract of land is quickly in- 
fected with the Plague, by means of the 
breath of the diseased and the steam or va- 
pour arising from the dead bodies, as to 
render the way of propagating this dreadful 
disease by infection entirely unnecessary. 
For though a person should keep cautiously 
at a distance from the infected, yet the air 



NATURE OF THE PLAGUE. 



141 



received in by breathing will of itself be suf- 
ficient to infect him, provided his juices be 
disposed to receive the infection/' 

In another place he observes, " that a 
few persons die of the disease for some years 
after a great Plague, and it usually goes 
off by degrees, because the pestilential con- 
stitution of the air is not yet entirely changed. 
Hence that the fevers which prevail for a 
year or two after a severe Plague are gene- 
rally pestilential, and though some of them 
have not the genuine signs of the Plague, yet 
they are much of the same nature, and re- 
quire a similar treatment/' — During the late 
Plague of Malta we were without a single 
evidence of the correctness of this statement. 
It will not be denied, I believe, that the dis- 
ease which visited that island in 1813 was 
justly entitled to be denominated a " great 
Plague" and yet I am justified in asserting, 
that not one case of a pestilential nature oc- 
curred after clean bills of health were issued, 
either in Malta or Gozo, What reasons ex- 
isted in the author's mind for the distinction 



142 EVIDENCE OF THE CONTAGIOUS 



he makes here between pestilential fevers and 
those which have not the genuine signs of 
Plague, I cannot conjecture. A fever must 
either be characterized by the genuine symp- 
toms of Plague, or it does not deserve to be 
called pestilential at all. To say then that 
fever can arise, having symptoms much of the 
same nature of Plague, and yet which have 
not the genuine signs of the disease, if it be 
not a manifest contradiction, is, to say the 
least of it, not a very clear mode of ex- 
pression. 

In the following passage there seems to be 
an unqualified recantation of his opinion that 
the Plague is produced by a particular con- 
stitution of the atmosphere. " I much doubt 
if the disposition of the air, though it be 
pestilential, is of itself able to produce the 
Plague, but that always being predominant 
in some place or other, it is conveyed to 
others by pestilential matter or the coming 
of an infected person from some place where 
the Plague prevails, and that even then it is 
not epidemic unless the constitution of the 



NATURE OF THE PLAGUE. 143 

air favors it. Otherwise I cannot conceive 
how it should happen that in the same cli- 
mate at the time the Plague rages violently 
in one town, a neighbouring one should to- 
tally escape it, by strictly forbidding all inter- 
course with the infected place, an instance 
of which we had some few years ago when 
the Plague raged with extreme violence in 
most parts of Italy, and yet the Grand 
Duke, by his vigilance and prudence, en- 
tirely prevented its entering the borders of 
Tuscany. After these explicit acknowledg- 
ments, I believe it will not be necessary for 
me to proceed farther to prove that it was 
even Sydenham's opinion that the Plague is 
strictly a contagious disease. Nor should I 
have trespassed with so prolix citations from 
this author, but that besides the reasons al- 
ready stated, I am willing to shew how 
toughly he wrestles with his latent atmos- 
pheric principle, before admitting the ne- 
cessity of a contagious one. In fact, he 
becomes, in place of an opponent to con- 
tagion one of its most decided advocates. 



144 EVIDENCE OF THE CONTAGIOUS 



and his concessions, as if extorted from his 
prejudices, are much more convincing than 
if he had undertaken to argue elaborately 
in defence of the doctrine which it*was ob- 
viously his aim to overthrow 

But that the Plague does not, as con- 
tended by Sydenham and many modern 
writers, extend from the infected subject to 
any great distance through the air, will be 
proved by the following fact which, in my 
judgment, deserves also to be received as 
one of the most conclusive which, probably, 
has ever been cited in support of its conta- 
gious character ; I allude to the escape of 
the attendants and others engaged with my- 
self in the service of the Military Pest Hos- 

* Putting aside the other incongruities in which the above rea- 
soning is involved, we find the author admitting not less than 
three distinct modes, by which the propagation of the Plague 
may be effected— first, being produced independently by the 
latent or secret disposition of the air — secondly, yet requiring 
the intervention of contact wit ! i an infected subject immedi- 
ately or mediately,— and, thirdly, extending from the in- 
fe2ted subject wholly independent of contact through the 
medium of the air alone. 



NATURE OF THE PLAGUE. 



145 



pital in Malta. The wards of this hospital 
were of moderate dimensions, (somewhere 
about sixteen or eighteen feet square,) so that 
if the effluvia from the bodies of the sick 
could have rendered the air infectious, it is 
impossible that these wards could have escaped 
becoming highly pestiferous. As circum- 
stances noted on the spot come with more 
force, and are less liable to error than mere 
general statement upon recollection, I will 
cite a passage from my communication to the 
Edinburgh Medical and Surgical Journal, 
published pending my services in that hos- 
pital, concerning the means by which we 
were preserved, and which will prove that the 
infection of Plague is not merely innocuous 
at a very short distance through the air, but 
may be» completely eluded by shunning con- 
tact, or by taking proper means to counter- 
act the effect of contact with the subjects of 
contamination. The passage is as follows : 
" Of all the means which have come to us 
recommended either in ancient or modern 
times, as productive of advantage in com- 

u 



146 EVIDENCE OF THE CONTAGIOUS 



passing the safety of persons engaged about 
the infected, I believe none are entitled 
to the same confidence as personal clean- 
liness, avoiding contact, or using immediate 
ablution after a foul contact, shunning the 
breath or the vapour exhaling from the 
bodies of the sick, ventilation, the fumes 
of the mineral acids, sustaining the animal 
spirits by generous living, and by exer- 
cise, and, lastly, though not less im- 
portantly, by the use of oiled silk dresses*, 
the texture of which is stopped up closely so 
as to prevent the transmission of any particles 
of infection (or any material emanation) 
from the bodies of the sick. During the 
Plague, which almost a century ago swept 

* These dresses were either of oiled silk or canvass. The 
material is called by the Italians tela cerata, its pores being 
stopped up by a composition, principally of wax. 

The dress consisted of a jacket, which was made to cover 
the whole upper part of the body, having a hood to fall over 
the head, but fitting it pretty closely, and with gloves of the 
same piece attached to the sleeves. A pair of trowsers 
completed the costume, which were of the same stuff, and 
long enough to descend to the ancles. 



NATURE OF TH£ PLAGUE. 14? 



off fifty thousand inhabitants in Marseilles, 
it was by these means alone, the mineral 
fumes excepted, that the faculty of physicians 
entirely escaped, though engaged throughout 
the whole of that calamity in the closest in- 
tercourse with the infected. The success of 
the same means as pointed out by myself * in 
our Military Pest Hospital fully establishes 
the value of this practice, not one of the at- 
tendants of any description having been at- 
tacked with the complaint, though in con- 
stant habits of handling contaminated sub- 
stances, and of coming into contact with the 
sick." When it is considered that the apart- 
ments which the Plague cases occupied were 
of so moderate dimensions, and that they were 
filled during the most destructive period of 
the summer, after the disease had acquired 
its highest degree of diffusibility, we cannot 
doubt that some remarkable cause must have 
existed to confer such a signal protection 

* I alluded here more particularly to the before-mentioned 
defensive dress, and the nitrous fumigation. 



148 EVIDENCE OF THE CONTAGIOUS 



from contagion of so virulent a character. 
Now if we reflect, first, that in those hos- 
pitals of the Maltese, where attention to 
cleanliness and the defence of the body from 
contact, were not rigorously observed, (al- 
though all the known means of purifying 
foul air were diligently practised,) the greater 
number of attendants were infected : if we 
reflect, secondly, that in the Military Pest- 
House, where cleanliness was rigorously ob- 
served and contact avoided, or counteracted 
by ablution, the attendants all escaped the 
disease, it would seem that the infection, if 
diffusible at all through the air, is so but at 
a very short distance*, and that, in short, the 
avoidance of contact is a certain protection 
against the contagion. 

To prove that the same means have been 

* Whether inhaling the breath or the vapour emanating; 
immediately from the bodies of the sick, might not be suf- 
ficient to communicate the disease, I am not prepared to 
give a confident opinion, though I should think this would be 
equivalent to contact, as the minute particles of infectious 
matter would be so immediately applied to the organs of 
respiration. 



NATURE OF THE PLAGUE. 



149 



found equally successful on other occasions, 
the following passage from De Mertens bears 
satisfactory testimony—" Solo aegroruin et 
rerum infectarum contactu comniunicabatur 
(pestis) atque atmosphaera contagium non 
spargehat, sed sanissima semper fuit. Visit- 
ando tarn prope adstabamus illis, ut sola pedis 
distantia inter nos et eos saepe vix remaneret 
et absque alia quacumque cautela quam 
quod nec corpus neque vestes, aut lectum 
tangeremus, a peste immunes permanserimus. 
Linguam propius observando solebam linteum 
aceto com muni imbutum naribus et ori ad- 
mo vere. Many equally authenticated in- 
stances are on record. 

I am aware, however, that our preservation 
in the Military Pest Hospital may be ascribed 
by some to the anti-pestilential power of the 
nitrous fumes which were diffused through 
the wards *. But when we consider the 

* Oil frictions were likewise employed by some of us, of 
which I shall have occasion to speak hereafter. See the 
article Prophylaxis. 



150 EVIDENCE OF THE CONTAGIOUS 



complete security conferred by the other means 
which have been mentioned as successful on 
occasions equally dangerous as our service in 
this hospital, and that in the native Maltese 
Hospitals no advantage whatever was appa- 
rently derived from nitrous fumigation, it is 
evident that this cannot claim to be regarded 
of itself as any specific or certain defence. Be- 
sides, if nitrous fumes were really deserving of 
being trusted to as a corrective of pestiferous 
emanations, so invaluable an antidote would 
undoubtedly have been long since independ- 
ent of any testimony derived from our expe- 
rience in any single hospital on any single 
occasion. 

The benefit of the dress which I re- 
commended was, in my judgment, not a little 
aided by the profuse perspiration which 
it produced, and which would most pro- 
bably have carried off any particles of in- 
fectious matter that might have come in 
contact with the skin before there was time 
for their taking effect. 

In my evidence before the Committee I 



NATURE OF THE PLAGUE. 



151 



find I have attached greater virtues to this 
dress than were actually meant. For, al- 
though it seems an excellent mode of ex- 
cluding pestiferous matter from the skin, 
and for preventing it being absorbed, I 
doubt that it would have proved so com- 
plete a protection, had not the other means 
of cleanliness been used at the same time 



SEC. III. 

Of marsh miasmata, considered as the source of pestiferous 
atmosphere. 

Among the various causes fancied to oc- 
casion the Plague, none have ever been 
insisted upon with more confidence than 
marsh miasmata, but I persuade myself a few 
remarks will be sufficient to exhibit the fal- 
lacy of this hypothesis, when applied to ac- 
count for the late Plague of Malta. 

* Almost the whole of the forzati, or convicts perished, 
though clad in this dress, during the execution of their duties 
of carrying' out the sick, the dying, and the dead, from their 
houses. 



152 



EVIDENCE 



OF THE CONTAGIOUS 



To make out a case proving the existence 
of a pestiferous quality in marsh miasmata, 
two things are necessary — first, that the 
Plague be observed to be primarily pro- 
duced and chiefly prevalent in the vicinity 
of marshy ground, — and, secondly, that it 
cannot reach the inhabitants in situations 
which are excluded from the influence of 
these effluvia. In the foregoing detail the 
reverse of this is apparent, and we have seen 
that Casal Paola*, though situated on the 
edge of wet ground called the marsa, where 
agues were wont to be both frequent 
and fatal, was one of the latest and most 
slightly infected villages in Malta, not having 
been contaminated until the 25th of July, 
nearly three months and a fortnight after 
that of Valetta. It has already been ob- 
served, that the same good fortune attended 
those who resided in the neighbourhood of 
the marsh of Messida, though having in its 
vicinity a populous town called the Pieta, 

* This town was, at one time, found to be so unhealthy, 
that a great part of it was deserted by its inhabitants. 



NATURE OF THE PLAGUE. 153 

which was separated from Valetta and Flo- 
riana by a small estuary of Marsamuchet 
Harbour. Yet the neighbourhood of Mes- 
sida was not infected for thirteen weeks after 
the Plague reached Valetta. — Lastly, the 
marsh of Puales produced a few agues this 
year, but no case of Plague was disco- 
verable any where in its neighbourhood. — 
To bring proofs to shew that the infection 
did not reach the inhabitants in situations 
which were excluded from the influence of 
marshy exhalations, would be only to reca- 
pitulate a great part of the matter contained 
in the foregoing pages. 

Against these remarks, it may be argued 
that the causes which produce marsh effluvia 
exist in apparently some of the driest and 
most elevated situations, nothing more being 
necessary to the evolution of this gas than 
vegetable matters acted upon by heat and 
moisture ; and a writer*, for whose talents 

I have a high respect, has stated that these 



* Dr. Bancroft. 



154 EVIDENCE OF THE CONTAGIOUS 

agents may account for the production of the 
fatal epidemic fevers on the rock of Gibral- 
tar. Yet admitting that pestiferous effluvia 
may be thus evolved, it still remains to be 
shown why those places in the vicinity of 
marshy or moist ground, were not the most 
severely visited by Plague, as well as the 
earliest scenes of its desolation. There is 
likewise reason to presume that the disorder 
would commence at a season when marsh 
fevers are most usually prevalent, or if at a 
different season, at least under some peculiari- 
ties in its state, discoverable by the senses. 
But in Malta it began when such fevers are 
hardly ever known in the island, and under 
circumstances the least of all favorable to 
any idea of deterioration in point of its soil 
or climate. Had it been otherwise, it is un- 
accountable that the Maltese, in their ex- 
treme anxiety to ascertain the cause of their 
disasters, should not have been able to fix 
upon some pretext in the state of the wea- 
ther, or deviation from the ordinary course 
of the seasons, to bear out at least a plausible 



NATURE OF THE PLAGUE. 155 

conjecture to account for their misfortunes. 

Neither is it reconcilable with the charac- 
ter of its marshy origin, that all foreigners 
from a cooler climate should have been less 
tlie victims of pestilence than the natives 
themselves. In the West Indies and other 
warm latitudes, where marsh fevers are pecu- 
liarly destructive, strangers from temperate 
climates suffer always more readily and with 
greater severity than the natives do, or than 
persons who, though not natives, have been 
some years resident in those countries ; a fact 
which has given rise to the common notion 
that a seasoning is necessary to protect 
a foreign constitution from the influence 
of such climates. But in Malta the natives 
of a cooler climate were almost all fortu- 
nate in escaping the contagion, especially 
our own countrymen. 

If Plague be the product of either soil or 
climate, it is mere trifling with common sense 
to allege that Malta could be free from pesti- 
lential visitation for a century and half; and 



156 



EVIDENCE OF THE CONTAGIOUS 



before so great progress was made in the arts 
conducive to health and comfort, it appears 
impossible that marsh effluvia must not have 
been even more liable to produce noxious 
effects upon the human frame, than since the 
condition of the country and its inhabitants 
in every respect has been so much improved ; 
to which I may add, that at no period was 
Malta ever known to have been in a more 
flourishing state, or in the enjoyment of a 
higher degree of health and comforts of every 
description, throughout all classes, than just 
anterior to the Plague of 1813. 

In Sicily the diseases arising from ma- 
laria, (which is only another name for marsh 
effluvia), are every year both frequent and 
destructive, and if this could give birth to 
the Plague, it is quite unaccountable that 
that Island should escape being often the 
scene of pestilential ravages, more especially 
as the frequency of earthquakes could not 
but occasion the disengagement of every 
noxious impregnation and combination which 
the advocates for the atmospheric doctrine 



NATURE OF THE PLAGUE. 



157 



so much insist upon as occasioning a pesti- 
lential constitution of the air. 

It has been advanced by some writers, that 
as Plague is only a higher degree of marsh 
fever, common agues do not make their ap- 
pearance at the same time. But in Malta 
several cases of ague occurred as above no- 
ticed in the vicinity of marshy grounds, 
first appearing in June *, and continuing to 
occur until September. 

Of the co-existence of Plague and marsh 
fevers we have numberless proofs in every 
country, and Dr. Sims, in his report of the 
epidemics of the last two centuries, states, 
that whilst the Plague raged in the South 
of Europe, agues and putrid fevers were very 
common. 

The following table, comprising a diary of 
the heat of each day, with its corresponding 
mortality by Plague, will point out the error 
of ascribing the disappearance or fluctuations 

* Here it appears that in my evidence before the Com- 
mittee, I was mistaken in confining the agues of this year to 
the autumnal months. 



158 EVIDENCE OF THE CONTAGIOUS 



of the malady to any changes in the tem- 
perature of the atmosphere. This register 
commences from the first day the disease 
was officially reported as infecting Valetta. 



NATURE OF THE PLAGUE. 



159 



A, D. 18lB 
Day of the 


Temperature, A. 


M. 


Temperature, 


P. M. 


No. of 
Deaths. 


Month. 
. 










— — 


April 16 


8 o'clock 


61 


_ 

2 o'clock 


64 




17 


8 

H 


63 
60 


2 


65 




l ft 
lo 




64 


o 


fin 




19 


7 


55 


9 


57 


1 






50 








10 ] 


65 








21 


8 


59 


2 


60 




22 


7 


58 


Q 
o 


60 




23 


8 


60 


4 


66 




24 


6 


60 


2 


71 






11 1 


63 
67 








26 


9 


64 


3 


65 




27 


8 


64 


4 


67 




28 












29 


7 


65 


5 


70 




ou 




64 








10 I 


65 








May 1 


7 


64 


4 


71 






l2i 


60 










72 


i n 
1U 






3 


7 


64 


8 


64 


2 


4 


7 


63 


4 ! 

8 > 


69 
64 




5 


8 


64 








6 


7 


67 






1 


7 


6 


64 


10 


62 




8 


8) 


67 








m 


72 








9 




67 






1 


45 


75 








10 


8 


72 


4 


74 




11 


7 


69 


3 


75 





160 EVIDENCE OF THE CONTAGIOUS 



A. D. 1813. 










No. of 
Deaths. 


Day of the 
Month. 


Temperature, A. 


M. 


Temperature, 


P.M. 


— — 

Ma\ 12 


6 o clock 


/ • - 
oo 






. — 

1 


13 


7 ) 

12 5 


68 
75 


6 o'clock 


70 




14 


5 


65 


1 ^ 


4® 








10 s 


67 




15 


6 


65 


4 


77 




16 


6 


09 


3 


79 


3 


17 


5 


64 


4 


78 




18 


6 


64 


4 


74 


2 


19 


8 


71 


3 


77 


8 


20 


7 


69 


6 


70 


10 


21 


6 


64 






6 


22 


6 


65 






6 


23 


8 


70 




76 


4 






12 S 


77 




24 


8 


72 


3 


80 


7 


25 


6 


64 


4 


76 


4 


26 


8 • 


71 




75 
71 


5 


27 


/ » 
o 


65 


4 


76 


5 


28 


6 


67 






7 


29 


8 


74 






16 


30 




75 








12 S 


80 






10 


31 


6 


71 


4 


82 


12 


June 1 


6 


71 


3 


84 


18 


2 


8 


70 


4 


78 


8 


3 


9 


72 


3 


77 


13 


4 


6 


71 


3 


82 


19 


5 


6 


70 


2 


78 


16 


6 


6 t 
12 S 


70 

80 






24 


7 


8 


75 


4 


76 


19 


8 


6^ 


73 


4 


76 


28 



NATURE OF THE PLAGUE. 



161 



A. D. 1813. 
Day of the 
Month. 



Temperature, P. M. 



June 



9 
10 

11 

12 

13 

14 

15 

16 

17 

18 
19 
20 
21 

22 

23 

24 

25 
26 

27 

28 

29 

30 



July 1 



8 o'clock 
6 



11 \ 



6 
10 

10* 

6 ] 
9S 

10 

w 

6 
10 

8 

6) 
8 $ 
8 

6 J 
12 > 

7^ 

6 

8 

10* 

6 

6 * 
12 S 

8 



74 
71 
73 
78 
72 

75 

71 

78 
71 
79 
70 
76 
79 

71 
71 

76 
71 
69 
72 
74 
72 
75 
74 
71 

74 



72 
77 
69 

70 

83 

77 



Temperature, A. M. 



5j o'clock 
5 

6 



2 J 



73 
77 



78 
79 

80 

76 
82 

80 

77 
71 
76 
74 
79 
77 

79 

73 

79 

78 
70 
84 
80 
80 

82 



85 

86 
83 
79 



No. of 
Deaths 



24 
32 

27 

33 
33 

36 

19 

19 

23 

28 
21 
18 
24 

32 

29 

35 

23 

34 

39 
37 
44 
47 

53 

42 



Y 



162 EVIDENCE OF THE CONTAGIOUS 



A. D. 1813. 
Day of the 
Month. 



July 3 

4 

5 
6 
7 
8 
9 
10 
11 

12 

13 

14 
15 
16 

17 

18 

19 

20 
21 
22 

23 

24 
25 



Temperature, A. 



9 i o'clock 
10 \ 

9 

6 

6 

10 

8 

8 
11 
10 

8 

9* 

9* 
12 

10 5 

6 
9 
12 

7 5' 

6 * 
10 5 

8 

8 

6 ] 
9* 

8 

6 } 
12 5 

8 



Temperature, P. 



85 
87 

80 

76 
71 
77 
77 
77 
8H 
79 

78 

72 
76 
73 
77 
80 
77 

8U 
77 
83 

Do. 
76 
78 
76 
70 

75 

80 
76 
78 

78 

77 
85 
79 



No. of 
Deaths* 



2 o'clock 

l\ 

4 
4 
1 

3 
2 
3 
2 

S \ 
6 5 



5} 



3 i 

8 5 
1 

55 

1) 

9 5 

2 



88 


44 


85 




81 


53 


80 


43 


80 


49 


78 


58 


78 


55 


80 


51 


83 


52 


81 


56 


78 




75 


63 




59 


78 


55 




65 


81 


67 


62 




83 


36 



81 

82 

79 

80 
78 
80 
80 
79 
80 
78 

83 



50 

41 

43 
41 

55 

48 

45 
44 



NATURE OF THE PLAGUE. 163 



A. D, 1813. 






Day of the 
Month. 


Temperature, 


A. M. 


July 26 


12 o'clock 


80 


27 


6 


7-5 ' 


28 


8 1 
12 1 


79 

82 


29 


6) 
10 S 


80 
83 




6^ 


76 


30 




8L 




12 > 


Do. 


31 


8 


81| 


August 1 


9 i 
12 S 


81 
82 


2 




74 

82 




6 


79 


3 


8? 


81 S 




10 C 


83 


4 


6 


74 

84 




76 


5 


9 } 


83 




11 J 


84 






78 


6 


10 & 12 J 


81 




83 


7 


8) 


82 




11 * 


85 


8 


6) 


75 


8 j 


80 


9 


10 | 


80 
81 


10 


6 ) 
9 t 


75 

83' 



Temperature, P. M. 



3 o'clock 



1} 



'2) 

4> 



81 
82 
79 

84 
82 

81 

80i 



81 
81 

84 

83 

82 



85i 
84 

83 



No. of 
Deaths. 



53 
46 

64 

49 

53 
63 



58 
50 

48 



43 

35 
37 



81 24 
81 26 



164 EVIDENCE OF THE CONTAGIOUS 



A. D. 1813. 
Day of the 
Month 



Augustll 

12 

13 
14 

15 

16 
17 

18 

19 
20 

21 

22 
23 
24 
25 
26 



Temperature, A. M. 



6 ^o'clock 
12 > 

12 3 



61 
9> 

G \ 

12 J 

5 ) 
9* 

5 * 
9 S 

12 J 
6) 

10* 
9* 

12 J 

»] 

12 J 



6? 
12* 

6 M 

8 $ 

5 
9 



75 
75 
76 
71 
77 
81 
75 
75 

8(H 
75 
79 
80 
72 
78 
72 
79 
74 
78 
80 
73 
78 
79 
80 
78 

80^ 
82 

81 

76 
83 
77 
81 
70 
76 
68 
78 



Temperature, P.M. 



3 o'clock 

2 

2 

4 

3 
3 

4 

2 

3 



1 * 

35 



80 
81 
82 

81 

80 
78 

97 

80 

80 

84 

86 
84 

84 

81 

79 

81 



NATURE OF THE PLAGUE. 165 



A. D. ibl3. 
Day of the 
Month 



August27 

28 
29 
30 
31 

Sept. 1 
2 

3 
4 
5 

6 

7 

8 
9 
10 

11 

12 
13 
14 

15 



Temperature, A. M. 



8 ) o'clock 
115 

9 5 

6 l 
9 5 

6 l 
9 5 

9 S 



10 5 

6> 
9 5 

6§ 
10 



!1 



10 



6 * 

7) 
11 5 

5 

7 
7 
7 



78 
81 
76 
79£ 
77 
79 
73 
79 
74 
77 

74 
78 
72 
77 
71 
76 

75 
80 
73 
79 
74 
72 
80 

73 

75 

72 

71 
70 

66 

66 



Temperature, P.M. 



3 o'clock 

2 
2 



79 

81 

80 

79 



3 
1 

}] 

3 5 



76 

78 

80 
81 
81 

79 
81 

81 
79 



75 
74 

74 
7? 

78| 
78 



No. of 
Deaths. 



38 

27 

25 
29 
28 

26 

37 

33 
32 

28 

33 

34 

37 
31 

29 



17 
26 
17 

17 



166 



EVIDENCE OF THE CONTAGIOUS 



A. D. 










No. of 
Deaths. 

— — — 


Day of the 
Month. 


Temperature, A. 


M. 


Temperature, 


P. M. 


Sept. 16 


6 o'clock 


65i 


_ — _ 

1 o'clock 


76 


30 


17 


6 


68 


2 


78 


23 


AO 


io s 


66 
79 




80 


12 


19 


7 


70 


1 


76 


20 


20 


6 


66 


2 


78 


24 


21 






2 


78 


21 


22 


6 


70 






12 


23 


7 


74 


4 


78 


12 


24 




74 
77 


3 


75 


16 


25 


10 


77 


2 


76 


11 


26 


7? 
12* 


75 
794 


4* 


77 


11 


27 


7 


75 


2 


77 


19 


28 


7 


74 


1 


79 


12 




7. 

io ; 


75 
79 


2 
4 


79i 
77 
83 
83 


15 


*>0 


10 




1{ 
25 


14 


UCt, 1 


Gh 
10 


76 
82 


4 5 


83 

83 


16 


2 


7 ^ 
10 * 


79 
80 


is 


78 
75 
75 


12 
i — 




8 


78 


]\ 
4 S 


80 
76 


16 


4 


8 


71 


l\ 


75 
73 


16 


5 






2 


78 


7 


6 


10 


76 


3 


79 


6 


7 


10 


76 






14 


8 


7*| 


69 


4 


76 


13 


1M 


78 







NATURE OF THE PLAGUE. 



167 



A. D . 1&13. 
Day of the 
Month. 



Oct. 9 

10 
11 

12 

13 

14 
15 

16 



17 
18 

19 

20 
21 
22 
23 

24 

25 

26 
27 

28 

29 

30 



Temperature, A. M. 



»\ 

11 

6 

6) 
12 S 

6} 
10 S 
10 

7 



9 



6 \ 

11 $ 

8 

6^> 

10 ? 
12-> 

7 

12 \ 
7 

.*4 

12 S 
7> 

11* 
7 

% 

1 \ 

11 $ 
7 



73 
76 
76 
70 
70 
78 

em 

75 
74 
69 
70 
76 

66 
69 
70 

67 
74 
74 
71 
74 
75 
72 
75 
78 
74 
77 
74 
79 
67 
75 
72 
75 
70 

65 



Temperature, P. M. 



I 

4 



2 
1 



o'clock 78 
75 
78 
77 



75 

76 
77 

78 

72 
79 
74 
74 



73 

77 
79 



80 
77 
78 
79 

77 

73 
70 
67 



168 EVIDENCE OF THE CONTAGIOUS 



A. JD. 1&V6 
Day of the 

Mnnth 


Temperatnre, 


P. M. 


Temperature, A. 


M. 


No. of 
Deaths 


Oct. 31 


8 ^ o'clock 
12 5 


62 
62 


. 

3 o'clock 


61 


3 


Nov. 1 




62 


2? 

5 \ 


63 


1 


12 ' 


63 


61 




2 


7 


63 


4 


64 


1 


3 


7 


03 


9 1 
5 > 




3 


4 


8 ? 
11 fi ^ 


66 

68 


3 


71 


2 


5 


8? 


69 




67 


3 




JUL ' 


71 i 


05 ™ 


DO 




6 


7 1 


7ft 


3 


67 


3 


7 


11 5 


66 




68 


1 


Q 
O 


/ 


00 




t>y 


3 


9 


7 




1 


01.' 


1 






3 


67 




10 


ft •» 

19 l 


63 






2 


1 1 

X 1 


7 


58 


1 


nf\ 

7« 




1 9 


7 




4 


70 


2 




Q 
O 


60 


0 
0 


69 


2 


14 


7 ^ 

12 


60 
71 


2 


72 


2 


1 ft 
it* 




69 


4 


1" 




16 


11 > 


63 

OO 


3 


64 


1 


17 


7 


59 


1 


64 




18 










4 


19 


7 


62 


1 


64 


2 


20 


8 


62 


3 


63i 


2 


21 


7 


62 


1 


63 


1 


22 


8 


64 


2 


65 


2 


23 


7 


63 






1 


24 


9 \ 


62 
67 


2 


70 


2 













NATURE OF THE PLAGUE. 169 



A. D. 1813. 
Day of the 
Month 


Temperature, A.M. 


Temperature, P. M. 


No. of 
Deaths. 


_ 

Nov. 25 


8 o'clock 


66 


2 o'clock 


69 


I 


26 


8 


67 


3 


70 


A 

<*. 




8 


67 


1 


71 


1 
1 


28 


Q 


DO 






1 


29 


Q 

o 


62 


o 

A 


AT 
o / 




30 


8 


64 


4 


62 




Dec. 1 


8 


- 

57 


4 


64 




2 


9 


65 


Q 

o 


09 




3 


8 


64 


3 


68 




4 


7 


62 




AO 

oo 




5 


8 


59 


I) 


Ox 




6 


7 


53 


* 


fkA 

t>4 




7 


8 


64 


1 


70 




o 
o 


7 


67 




oo 




9 


7 


66 


3 


oo 




JO 


7* 


58 


o 
o 


o7 




11 


8 


57 


1 

J 


61 






8 


1 ^ 

1 i 

5 i 


63 




12 


56 


60 




13 


8 




2) 


60 




59 


8* 


67 




14 


8 ) 
12 S 


* 59 
63 








15 












16 












17 


8 


58 


3 


62 




18 


8 


56 


3 


59 




19 












20 


8 


62 








21 


8 


56 


3 


59 




22 


8 


57 


3 


60 




23 


8 


54 


4 


62 




24 


8 


56 


4 


55 





z 



170 EVIDENCE OF THE CONTAGIOUS 



A. D. 1818. 
Day of the 
Month. 


Temperature, 


A. M. 


Temperature, 


P. M. 


No. of 
Deaths 


Dec. 25 


8 o'clock 


54 


1 1 o'clock 
3 I 


58 
58 


— 


26 


9 


58 




60 










59 




27 


8 


59 


3 


61 




28 


8 


541 


2 \ 


56 








4 * 


54 






52 






29 


10 i 


53 








30 


8 


46 








31 


8 


49 


3 


54 





The whole amount of deaths in Malta 
to the end of November, was four thousand 
four hundred and eighty-six, after which the 
disease being chiefly confined to the Pest 
Hospitals, I could not obtain a return of the 
mortality. I continue the register, notwith- 
standing, as it may be satisfactory to some 
readers to see the variations of the thermo- 
meter carried up to the end of the year of 
the Plague *, 

* The reader is presented below with a Diary of the atmos- 
pheric variations during the greater part of April, in the year 
antecedent to the Plague, in order that by comparison with 
the foregoing Table, he may judge for himself how far there 



NATURE OF THE PLAGUE. 1?1 



An inspection of the foregoing Table, 
clearly shews that the decline of the malady 

were grounds for believing in the existence of any thing out 
of common course in the temperature or vicissitudes of the 
April of the Plague year, which could account for its being 
more than usually unhealthy. Various interruptions pre- 
vented my carrying down the Diary farther than the 6th of 
May. 

Some allowance will require to be made for the observa- 
tions being taken at noon. In the preceding Register they 
have been made either much earlier, or else generally at two 
or three o'clock in the afternoon, when the heat had attained 
its maximum. 



1S12. 


Temperature at Noon. 


1812. 


Temperature at Noon. 






April 19 
20 
21 


65 

67J 

67 


April 4 


64 


22 


66 


5 


63i 


28 


66 


6 


64 


24 


65 


7 


63 


25 


66 


S 


62£ 


26 


66 


9 


62 1 


27 


65 


10 




25 


66 


11 


63 


2& 


67 


12 


63 


3C 


67 


13 


62§ 


May 1 


68| 


U 


62 




68 


15 




3 


68 £ 


16 


64 


4 


6Si 


17 


65 


5 


69 


18 


66 


6 


69 



172 EVIDENCE OF THE CONTAGIOUS 

had no connexion whatever with the varia- 
tions of the atmospheric heat : and I need 
hardly remark, that had the cause re- 
sided in any respect in the state of the air, 
we might as well have expected to chain 
the winds as to restrain the spread of the 
disorder by the measures which were found 
so successful. 

By comparing the thermometrical indica- 
tions of the month of April in each of the 
years 1812 and 1813, it will be seen that 
the April of the latter year was decidedly 
colder than that of the preceding : the 
winds were northerly in both, and occa- 
sionally boisterous. The months of January, 
February, and March, immediately anterior 
to the Plague, were all cold months, and it 
was the universal opinion, that the March 
and April of 1813 were colder than in most 
former years. If all this be true, there is 
the less reason to presume that the Plague 
was the product of the atmosphere in that 
year, since cold is generally admitted to be 



NATURE OF THE PLAGUE. 



173 



not only adverse to its production, but in- 
compatible with its existence. 

I find, in my evidence before the Com- 
mittee, that I did admit some inconsiderable 
increase in the heat of the air whilst the dis- 
ease went on to decline. On a more minute 
review of the Table, it appears this admis- 
sion has been made against the fact without 
sufficient grounds ; for example, although 
after fthe imposition of more rigid restric- 
tions the deaths decreased very considerably 
in the course of the last fifteen days of 
July, the average heat of the weather was 
not greater or less than during the first 
fifteen days of that month. Neither was 
there above one degree of sensible variation 
in the mean heat of the weather for the 
first sixteen days of August, during which 
period the disease yielded so very rapidly ; 
so that, in short, the average temperature 
from the 1st of July until the 16th of Au- 
gust, comprising the whole period of its 
greatest increase, as well as decadency, may 
be regarded as equal. I have computed the 



174 EVIDENCE OF THE CONTAGIOUS 



mean heat by casting up the highest indica- 
tions of the thermometer on each day. 

It will be remarked, that on certain days 
about the latter end of June and the be- 
ginning of July, when the thermometer rose 
suddenly to a height which it never after- 
wards attained, the deaths were greatly 
augmented : on other days, when the heat 
as rapidly subsided, the very same re- 
sult followed. Moreover, whilst the tem- 
perature remained equal on different days, 
the mortality varied in an extraordinary de- 
gree, e. g. it amounted to only twelve 
deaths on the 31st of May — on the 15th of 
June, to nineteen — on the 29th of June, to 
forty-four — on the 16th of July, to sixty- 
seven — and on the 18th of July, to fifty* 
the thermometer on each of those days indi- 
cating about 82°. Again, although the 
extent of mortality remained equal, the 
changes of temperature were not less striking, 
e. g. on the 13th and 26th of June, we find 
a difference of ten degrees, and on the 12th, 
28th, and 31st of July there are also 



NATURE OF THE PLAGUE, 



175 



remarkable variations in the thermometer, 
so that whether the mortality continued 
equal, the temperature was very different, 
or whether the temperature remained equal, 
the mortality was not less inconstant. It 
would be a nugatory undertaking to pursue 
such remarks farther, every day's observation 
affording the clearest grounds to conclude 
that the fluctuations of the mortality bore no 
reference whatever to the changes of the 
atmosphere in point of heat. 

I am aware it is a general opinion that 
a considerable degree either of heat or cold 
is incompatible with the existence of the 
Plague. We had, however, no opportunity 
of seeing this exemplified in Malta, as the 
contagion was arrested in several places be- 
fore the least approach to any sensible, not to 
speak of considerable change in the tempe- 
rature of the air was perceptible. It is par- 
ticularly deserving of remark that the ther- 
mometer stood at about seventy-six or 
seventy-seven when the last case was an- 
nounced in Valetta, which was a degree of 



176 EVIDENCE OE THE CONTAGIOUS 



heat equal to that in which the contagion 
made its most rapid strides at an earlier 
period in this city. 

A numerous host of proofs to shew that 
the decrease of the disorder was wholly in- 
dependent of the state of the atmosphere 
as to temperature, is derived from its arresta- 
tion in several of the casals by restrictive 
regulations during the period of its widest 
dissemination in other places. It was, for 
example, exterminated in casal Lia early in 
June — casals Atard — Gudia — Zeitun — , 
Tarxien, Micabiba and Zurich, in July, and 
in Zabbar, Luca, and Paola in the month 
of August. It was also stopped in Cospicua, 
a populous town within the fortifications in 
July, and in Vittoriosa, another of the same 
description, in August. The following ex- 
tract from the Government Journal of 
Malta supplies definitive confirmation of all 
that has been advanced in reference to this 
subject.- — " All' apparir di questa infermita 
fummo assicurati che il caldo la estingueva, 
che il decrescir della luna ne sminuiva la 



NATURE OF THE PLAGUE. 177 

forza, che le ruggiade della notte la spegne- 
\ano, e che alcuni particolari giorni d'estate 
h iaceano tutto in un colpo svanire. Pero tutte 
queste cose che si verificarono in Alessandria, 
in Smirna ed in Aleppo non furono quasi di 
alaoi effetto in Malta ; ne il caldo la estinse, 
ne lldecrescer della luna porto alcun sensibile 
gioYLmento, ne il venir di alcuni giorni par- 
tico^ri la fece svanire/' Finally ; when to the 
whoie of this body of facts we add the rapid 
dimimtion in the number of attacks follow- 
ing almost immediately upon the rigid en- 
forcement of Police restrictions in the se- 
veral towns formerly mentioned, and at a 
period vhen the contagion had attained to its 
acme of diffusibility, no doubt, I think, can 
remain in any mind which is open to convic- 
tion, that it was to these measures alone the 
sudden cessation of the disease in those 
places was immediately to be attributed, 
and not to any alteration in the atmospheric 
influence. 

I regret much it did not occur to me to 
keep a hygrometrical diary, during my re- 



178 EVIDENCE OF THE CONTAGIOUS 

sidence in Malta, together with a register 
of the prevailing winds. But I am satisfied 
there was nothing in the state of the weather 
deserving especial notice in the year of tae 
Plague, with the exception formerly noticed, 
that the summer months in general were 
cooler, and, perhaps, more windy than in the 
year preceding. 

A notion prevailed among the Maltese, that 
whenever the wind increased, no matte; from 
what point of the compass, it became very 
generally followed by a corresponding in- 
crease in the number of attacks, and, on the 
contrary, that serene weather, though of an 
equal temperature, was succeeded by a dimi- 
nution in their number. Some attempted to 
account for this by supposing that the perspi- 
ration being rendered more profuse in calm 
weather was less favourable to theabsorption 
of the pestilential matter by the skin ; an 
exemption which, I may remark, by the 
way, could not have existed if the infection 
were received through the medium of the air 
by the lungs. It is, however, probable, that 
the coincidence was merely accidental. 



XATURE OP THE PLAGUE. 



179 



Two objections have been urged by those 
who deny that the dissemination of the dis- 
ease was ascribable to contagion; the first, 
that it must have been found to assail the 
different towns in the order of their proximity 
to each other, and the second (which is only 
a different mode of stating the first objection,) 
namely, that the disease would necessarily 
have assailed individuals more rapidly in suc- 
cession, and not in the irregular manner in 
which it extended throughout the inhabitants 
of Valetta. A moment's reflection will exhibit 
the insufficiency of these objections : For 
whilst the intercourse between the towns was 
unrestrained for a length of time, there mani- 
festly was nothing to forbid that an infected 
person or infected materials should as readily 
transport the disease at once into a more re- 
mote town as into one more contiguous, 
without coming m contact with any person on 
the intermediate line of their route, and ac- 
cordingly we find the casals infected in the 
very irregular order following : 



180 EVIDENCE OF THE CONTAGIOUS 









From Valetta. 


Gudia 


on the 18th of May 


3 miles 


Rabato 


20 




6 


Atard 


22 




31 


Curmi 


do 




2 


Luca 


23 




2* 


Zeitun 


24 






Zebbug 


26 




4 


Bircarcara 28 




2 


Zabbar 


31 






Micabiba 


I 


June 


4 


Chercop 


4 




3£ 


Li a 


6 




3| 


Zurich 


17 




H 


Musta 


8 


July 




Tarxien 


21 


% nearly 


Paola 


25 




3. 


Siggeui in 


September 




4? 

^2 


Dingkli in 


October 




8 



That the infection did not spread in Va- 
letta more regularly from each individual to 
his neighbour, or from one house to the next 
in its vicinity, is of course equally accounted 
for, as in respect to the contamination of the 
casals. We have no right, however, from this 
apparent irregularity, to assume that the con- 
tagion did not extend with every exactness to 
those who were either immediately or medi- 
ately in contact with the infected ; but on the 
contrary, we have had the best reasons de- 



NATURE OF THE PLAGUE. 



181 



rived from its progress for several weeks after 
its commencement in Valetta,to conclude that 
it does always so extend, without deviation. 
That the disease was not more rapidly diffused 
at the first may be explained by the state of 
the air, and other circumstances not favoring 
its contagious power in so great a degree as 
afterwards, and because under any circum- 
stances, contagion is (most fortunately) not 
governed by a necessity of exerting its in- 
fluence upon all individuals alike who come 
in contact with the subjects of contamination. 
This would be contrary to experience, not only 
in regard to the Plague, but to every other 
disease which is admitted to own its propa- 
gation to this cause. We do not, in fact, 
know in any contagious disease what it is 
that constitutes the susceptibility of the hu- 
man subject, in order to ascertain under what 
conditions the contagion must, of necessity, 
be propagated ; for, to use the words of 
Cullen, " some of the most powerful con- 
tagions do not operate but when the bodies 
of men exposed to them are, in certain cir- 



182 EVIDENCE OF THE CONTAGIOUS 



cumstances, which render them more liable 
to be affected by it, or when certain causes 
concur to excite the power of it, and, there- 
fore, by avoiding these circumstances and 
causes, they may often escape infection." 

To constitute an effectively pestiferous 
contact, many concurrences, of which, in 
the present state of our knowledge we are 
entirely ignorant, may be indispensable. 
For example, it may be requisite that a cer- 
tain state of the air as to heat and moisture, 
should co-operate with a peculiar condition of 
the skin ; that the contact should take place 
at a particular period of the disease, and be 
continued for a due length of time ; that 
the constitution of the individual exposed to 
the infection should be united with a certain 
temperament ; that he be exempt from cer- 
tain diseases ; that the cuticle in contact 
with the poison should be in a peculiar 
state to fit it for absorption ; in short, so 
many such circumstances meeting at the 
same instant, may be required to render 
pestilential virus operative, that if they were 



NATURE OF THE PLAGUE. 183 



all known to us, we might rather be sur- 
prised that the visitation of countries by 
pestilence is so frequent an event as we find 
it, in place of considering their long escape 
as an argument for doubting the reality of 
its importation. 

In chemistry we have certain knowledge of 
the nicety required to produce results when 
only one or two agents are concerned. 

It is scarcely possible, even when we 
bring a saline solution to the same state of 
concentration, to obtain, by its cooling, 
crystals of precisely the same magnitude and 
form. We find the whole process influenced 
by the rate of cooling, the quantity of 
liquid, the size and shape of the vessel, the 
materials even of which it is composed, the 
degree of exposure to the air, and appa- 
rently, also, by peculiarities of the atmos- 
phere, incapable of being detected with pre- 
cision — such as its electric state, or its hy- 
drometric condition. The addition of the 
smallest portion of another salt to the one 
which has been dissolved, will modify, en- 



184 EVIDENCE OF THE CONTAGIOUS 



tirely, its form, and even its more important 
internal crystalline structure. And hence, 
from such causes in Nature more particularly, 
where every thing is conducted on a larger 
scale, a substance essentially the same by 
all chemical tests, is found often under the 
greatest diversity of crystalline forms. 

The communication and diffusion of heat 
might afford similar illustrations. For ex- 
ample, it is from this cause difficult to 
bring the same liquid to boil at the same 
temperature precisely, in two vessels of the 
same size and shape, but of different mate- 
rials. A compound gas transmitted through 
a metallic tube, placed across a furnace, will 
suffer a different kind of decomposition to 
that which the same gas will suffer from 
being transmitted through an earthenware 
tube, under precisely the same circum- 
stances, though the metal produce no effect 
by any chemical affinity. 

The mere scratching of the surface of a 
vessel will modify the rate of its heating or 
coolino;. And if we cover its surface with 



NATURE Or THE PLAGUE. 185 



successive pellicles of any substance that can 
be closely applied to it, we not only modify 
its rate of cooling, but do so under very dif- 
ferent proportions, according to the number 
of pellicles we add. 

The expansion of a metal is not merely 
dependent upon its chemical purity, but on 
very slight changes of aggregation ; so that 
from two fragments of the same bar, one 
hammered, the other not, we shall obtain 
different degrees of expansion from the com- 
munication of precisely the same increment 
of temperature. 

The cases of chemical affinities would 
supply endless illustrations. Even in the 
most common practical operations an uni- 
formity of circumstances is requisite to obtain 
the same product from the mutual action of 
the same substances in the same relative 
quantities. — The order in which they are 
presented to each other— the degree of dilu- 
tion in which thev exist — the agitation com- 
municated — the state of temperature — cer- 
tain periods of time- — -all these circumstances, 



186 EVIDENCE OF THE CONTAGIOUS 

in short, produce variations of the utmost 
importance. I may give merely one example 
(a striking one), of the necessity of peculiar 
arrangements to effect combinations, and 
those even of no complicated nature. It 
may be taken from the formation of a triple 
salt, which has lately been the subject of in- 
vestigation, and is one of importance, as 
being, probably, an ingredient in the Chelten- 
ham waters and other saline mineral springs, 
namely, the triple sulphat of magnesia and 
soda *. It consists of sulphat of magnesia, 32 
— sulphat of soda, 39 — and water of crystalli- 
zation, 28 or 29. The most obvious method 
ol forming this salt would be to dissolve the 
two sulphats in the above proportion in 
water, and evaporate the solution to crys- 
talization, and scarcely any chemist would 
hesitate a priori to conclude, that in this 
way it could be obtained. In this way, 
however, it cannot be formed. The two 
salts crystallize apart, and it requires indirect 



* Vide Edinburgh Philosophical Transactions, vol. vii. 



NATURE OF THE PLAGUE. 18? 



methods to effect their union, and thus to 
establish an affinity apparently even of the 
simplest kind. In the excitation of galvanic 
action nothing is more difficult than to obtain 
uniformly equal effects even from the action 
of the same liquid applied to the same num- 
ber of metallic plates ; and the chemical 
actions of these forces or bodies, are so 
powerfully modified by slight causes, that 
while water, perfectly pure, will be decom- 
posed with the greatest slowness at the re- 
spective poles, the addition of the most mi- 
nute portion of saline matter will cause it to 
be decomposed with great rapidity. The 
excitation of electricity, it is well known, is 
equally dependent on slight variations of 
circumstances, so that the management of 
the electrical apparatus always requires a 
considerable exertion of care and skill. 

In the operation of agents on the human 
body, either chemical, or partly chemical, 
and partly physiological, there is not less di- 
versity in the results. The galvanic shock is re- 
ceived in very different degrees of intensity 



188 EVIDENCE OF THE CONTAGIOUS 



from the same battery by different indivi- 
duals. There are certain effects produced 
by the gases on the animal system by inspi- 
ration, which are liable to be varied consi- 
derably in degree, and even in kind of ac- 
tion, not only in different species of animals, 
but in different individuals of the same spe- 
cies. To recur to one striking example, and 
a familiar one — the effects of the nitrous 
oxyd, though usually highly exciting, are 
still, in every case, perhaps, peculiar, and 
strikingly so in every individual, and even 
in the same individual at different times. 
In a state of vigor, for instance, or of lassi- 
tude, the same quantity inspired will pro- 
duce the greatest difference in the effect. 
The powerful debilitating agency of car- 
burretted hydrogen has been found to be 
very unequal on different animals ; and it 
has also been affirmed that it becomes less 
powerful after the inspiration of the gas has 
been long and repeatedly continued. 

To brins: illustrations more immediately 
connected with the subject. It is well 



NATURE 



OF THE PLAGUE. 



189 



known by those who have experience in cow- 
pox, that a peculiar rough state of the cu- 
ticle, consisting in its elevation at the roots of 
the hairs, and which is very common in the 
healthiest subjects, will completely prevent 
the vaccine matter from taking effect ; and 
in like manner, that the presence of some 
cutaneous diseases do for a time fortify the 
constitution against others. We every day 
observe the greatest uncertainty in the sus- 
ceptibility of certain individuals of the effects 
of poisonous and narcotic substances, and 
that these substances act upon the same in- 
dividual totally in a different way at different 
times. Opium, in the same dose, will, at 
one time produce deep sleep, at another 
watchfulness, and wine is not less capricious. 
Henbane will not act at all on some habits 
as a sedative, but produces purgation. Many 
escape syphilis for a great period of their 
lives, but at another become extremely sus- 
ceptible ; and even the bite of a rabid animal 
is innocuous to certain constitutions, though 
in others the mere application of the virus to 



190 EVIDENCE OF THE CONTAGIOUS 



the surface is almost immediately followed 
by all its frightful symptoms. May we not 
conclude then that the pestilential poison 
may be equally capricious in its action as 
any of these, depending upon causes, and 
governed by laws peculiar to itself. 

The many instances which occurred during 
the Plague of whole families escaping the 
contamination after having lived long in the 
most intimate communication with the in- 
fected, proves to what a great extent non- 
susceptibility may exist. Several cases were 
known to me of individuals, labouring under 
the greatest violence of the disorder, being 
taken from the very bosom of their families, 
without communicating to them any injury 
— -children from their parents — and hus- 
bands from their wives. ^ Yet these fa- 
milies had used no kind of precaution what- 
ever ; indeed, in most instances, not so much 
as an attention to common cleanliness. In 
De Rolle's regiment cases were taken from 
the very heart of a company, so urgent as to 
prove fatal in a day or two, whilst the rest of 



NATURE OF THE 



PLAGUE. 



191 



the men continued in perfect health ; nei- 
ther was there here any assignable cause to 
which their escape could be attributable 
—oil-frictions — fumigations — or any other 
kind of precaution, preventive, or antidote. 
My own calesse-man and two of his children 
died of Plague, but his wife was never in- 
fected, nor his brother-in-law, though con- 
stantly attending on the family in their illness. 
These people were also very neglectful of 
personal cleanliness, and used no kind of 
precautions whatever. 

As an objection to contagion, it has been 
advanced that the Plague arises and disap- 
pears at certain determinate periods of the yeai\ 
independently altogether of any interference 
on the part of the police ; an assertion which, 
however, is unsupported by fact, as the 
disease is known to commence in the same 
country under every diversity as to the 
seasons ; in proof of which we need go no 
farther than the last two Plagues of Malta, 
the former having commenced in the month 
of December, three months previous to the 
time of its appearance in 1813. 



192 EVIDENCE OF THE CONTAGIOUS 



Another objection taken against contagion 
in Plague proceeds from the idea that if the 
disease could be capable of infecting per- 
sons twice, the human race must long ago 
have been exterminated. But before this 
inference can be admitted, it will be incum- 
bent on its supporters to explain why the 
same consequence has not resulted from other 
* contagious disorders, as well as the Plague. 
The fact is, that in all diseases of this cha- 
racter, those who have suffered once are 
generally less liable to a recurrence of at- 
tack ; and in typhus fever, whether we con- 
sider it contagious or not, instances of 
second attacks are far from being frequent. 

It will not be denied, however, that many 
objections and difficulties may be thrown in 
the way of the doctrine I have been endea- 

* The occurrence of small-pox a second time in the same 
individual, however it may be doubted or disbelieved by 
some, is fully established by the most respectable au- 
thorities. The instances, it will be allowed, are rare, but 
the recurrence of a milder variolous eruption after small pox 
is by no means so unfrequent an event; and in the Plague, 
likewise, the succeeding attacks are usually milder than 
those which precede them. 



NATURE OF THE PLAGUE. 193 



vouring to support, which may baffle every 
attempt to explain. But were it allowable to 
discredit the validity of any doctrine merely 
because it is possible to advance objections 
of an unanswerable kind, the same argument 
would equally authorize the rejection of many 
of the most important and practically useful 
deductions in natural science. I am willing, 
however, to flatter myself that the contagious 
character of the Plague has been made out 
in the foregoing chapters as decisively as can 
be necessary to remove the doubts of any 
earnest enquirer ; not merely by circum- 
stantial evidence, but by direct proofs and 
a series of converging facts not to be recon- 
ciled on any other principle without many 
very glaring violations of probability. Such 
evidence will, therefore, be entitled to govern 
our practice until some clearer light shall be 
set up to shew us our delusion * : and I need 

* If it be a delusion to believe the Plague contagious, we 
must allow that it is one which has prevailed from the ear- 
liest times, under sanction of the highest authorities ; and, not- 
withstanding all that has of late been said to the contrary, there 

2 c 



194 EVIDENCE OF THE CONTAGIOUS 



is positive evidence, if any meaning is to be attached to words, 
that some of the greatest Physicians, Poets, and Historians 
of antiquity, were as thoroughly convinced of the existence 
of contagion as a property belonging to the Plague and 
other diseases, as we are assured of the fact by our expe- 
rience at the present day ; in proof of which, 1 believe the 
following passages out of numerous others, are more than 
sufficient for every purpose of satisfying any reasonable mind. 
I offer them without commentary, as they seem to me alto= 
gether independent of any such aid. 

Aid r) dtio /x£v voa-wv Ivlm voata-iv 01 vXviatdZpvrts «Vc <>f vytiixs 
£s)s vyid^sreci ; AR1STOT. PrOB 

Asts %s |y^o/«v re, xdi <rvvhxtrd<r8at f » /as<ov tj Xotf^u, dvamvoris ydg 
is fxtrdtoaiv "pvi&lri Bxtyv) A RET MVS . 

arvvo^ixrpiCsiv rots Xot^urmcriv s'JTtatyxXss, dmoXaxtcrai yap kIvSvvqs 
tea-ireg ^/ocpas r/vo? r, otyQaXfAtas, GALEN. 

Aid ri itors o Xoiy.oy (j.6vr) Twv vqcwv f^dXtsx Tbs TTXyaridfyvTas rcti 
Qspausv^svots r npoaavxml^ r rtXr i o'i. ARISTOT. 

srspos dty* erspu f Qsgawsias dvx r ni^. f nXd^svoi y uawep rd irplQarx 
IQvvi&icov' xa) irX'ssov tyOopov ISro svsnolsi' sirs yap (aw QsXots* 

^^torss- dKKxXois upcxr'isvxi, dituKhvvro sp^ot, v.dt Iikioli noKkat 
sKivw%a-xv unop'toi t5 9spa7rsvaavros' sirs vtpoalolsv §istyQs!govro> K a j 
(/.xhisa 01 apsrvis rt ^srx r noia^svot. Thucidides. 

Totua&s xv lovras rls hk civ tyvyoi, vi rls 8* av sv.rpa , nsli) > v.riv des, 
r, mxr%g s'fr x»% xxaiyvmros Tv%rt', Slog xa) duty) ^sra^lcrtos rtt 



not add, that the proof 
carry much weight which 




Aretjeus. 



NATURE OP THJE PLAGUE 



195 



opposite side of the question, before any de- 
parture from the usage of nations, in re- 
Quo propior quisque est, servitque fidelius a?gro 
In partem lethi citius venit. Ovid. 

Postea curatio ipsa vulgabat morbos. Liv. 
Vulgatique contactu in homines morbi. Ibid, 

Pusula nisi compescitur intra primam pecudem, universum 
gregem eontagione prosternit. Columel. 

— — — Nullo cessabant tempore apisci 
Ex aliis alios avidi contagia morbi. 

Qui fuerant autem praesto, contagibus ibant. Ovid 

Quidam ex Asia, lichenarum eontagione important. Plin. 

Vereor ne hoc quod infectum est, serpat longius, 

Cic. ad Attic, 

Contagium morbi etiam in alios vulgatum est. Curt. 

— — Priusquam 

Dira per incautum serpant contagia vulgus. Virgil. 

Polia laurus pestilentiae contagia prohibent . Plin, 

Ant neglecti desertique, qui incidissent morerentur; aut 
assidentes curantesquc eadem vi morbi repletos secum 
traherent. Liv. 

=— r '.— Fcetas 

Nec mala vicini pecoris, contagia laedent. Virgil. 

Post ubi contagio, quasi pestilentia ? invasit Sall* 



19£> EVIDENCE OF THE CONTAGIOUS, &C. 



ference to the quarantine laws, can be justi- 
fied, seeing that the risk attending the neglect 
of these laws, did any doubt remain on the 
subject, is so frightfully disproportioned to 
any inconveniences which they occasion. 

Nec tondere quidem morbo, illuvieque peresa 

Vellera, nec telas possunt attingere putres. 

Verum etiam invisos, si quis tentarat amictus 

Ardentes papulae, atque immundus olentia sudor 

Membra sequebatur : nec longo deinde moranti 

Tempore, contactus artos sacer ignis edebat. VlRG. 



197 



CHAPTER VI. 

On the prevention of the Plague. 

That as man continues, age after age, to 
disregard the lessons of experience, there is 
but a slender hope of his condition being 
materially improved, was the reflection of a 
profound observer * ; and the force of it was 
indeed most fatally exemplified during the 
late Plague of Malta. Upon that unhappy 
occasion, the vigorous precautions long 
sanctioned by the practice of mankind, and 
repeatedly proved to afford the only chance 
of protection against this insidious disease, 
were so tardily or imperfectly carried into 
execution, that it became impossible to put 
an immediate stop to its progress. Indeed, 



Voloey. 



19o ON THE PREVENTION 

the events of that crisis, if we had no other 
evidence, abundantly point out the necessity 
of every country liable to this scourge, being 
provided with an efficient code of health laws 
ready to be acted upon at the shortest notice, 
and that the due execution of these laws, so 
far from being discretional, ought to be ab- 
solutely imperative upon those to whom their 
administration is entrusted. To exemplify 
the truth of these remarks, it will not be ne- 
cessary for me to refer beyond the measures 
adopted by the government of Malta in 
1813. 

In looking back to the histories of other 
Plagues, (as well in Malta as elsewhere,) I 
often discover that the time which ought 
to have been occupied in prompt and en- 
ergetic action, was irretrievably lost in deli 
berations, remarkable for little beside their 
impotence and indecision. Long after the 
Plague was detected in Valetta on the last 
occasion, the decrees of Public Health were 
exclusively taken up with merely recommend- 
ing measures of secondary importance 5 in 



OF THE PLAGUE. 



199 



place of peremptorily requiring obedience to 
those upon which the efficacy of every other 
depended, and whilst daily proclamations of 
wearisome prolixity teemed from the press, 
announcing the expediency of purifying, ex- 
purgating, scouring, whitewashing, &c. &c. 
there were no decided steps taken to prevent 
the pestiferous congregation of the inha- 
bitants, either in the streets or houses. It is 
a remarkable coincidence, that Malta was 
doomed to a similar fate by the same pro- 
crastinating system in the former Plague of 
l6'75 ; and we are told by the historian of 
that event, that before the name of the dis- 
ease was decided upon its progress had be- 
come irresistible. Many of the voluminous 
proclamations of 1813 were occupied with 
little besides remonstrances against disobe- 
dience of orders, and contained statements 
more fitted to beget distrust as to the nature 
of the distemper, than to reconcile the people 
to the sacrifices which were indispensable for 
their deliverance. Nay, the very punish- 
ments which were decreed for disobedience, 



200 ON THE PREVENTION 



as they were not followed up*, must have 
been calculated to produce indifference ra- 
ther than proper respect for the authorities 
which issued them, 

" And as fond fathers 
Having bound up the threatening twigs of birch 
Only to stick it in the children's sight 
For terror, not for use ; in time the rod 
Becomes more mock'd than fear'd ; so their decrees 
Dead to infliction, to themselves were dead." 

But, beside the want of determination 
which marked the measures of this period, 

* The amiable dispositions of the late civil Commissioner 
satisfied me that this leniency was dictated by the purest 
and most benevolent intentions, and one has only to regret 
that he should, in point of fact, have so widely mistaken the 
road to mercy, and been ignorant of the value of a more ri- 
gorous exercise of his authority. The precept of Muratori 
ought never to be lost sight of in such emergencies : " Non 
la mansuetudine e piacevolezza ma i! rigore e qui necessaria 
a chi governa." One or two examples made at the begin- 
ning would have outweighed volumes of mere denunciations. 
The hero of la Mancha himself was not ignorant of this, who, 
however speculative his notions may appear on other sub- 
jects, made no bad pretensions to legislative skill, as will 



OF THE PLAGUE. 



201 



and which were calculated to induce a belief 
that their authors themselves were far from 
convinced of the actual danger of their situa- 
tion, some degree of doubt, as to the presence 
of Plague, was liable to be excited in the pub- 
lic mind by the undecided terms in which 
even the reports of the Health Department 
were conveyed. 

In support of these remarks, I shall pre- 
sent the substance of certain official orders 
published under the authority of the Malta 
Government for some months after the island 

be seen by the following admonitions given to Sancho, when 
about to enter upon the arduous duties of his government: — 
" Do not issue a great number of ordinances, but take care 
that those which are published be good, and, above all 
things, see that they are maintained and put in execution ; 
for those ordinances which are not observed, might as well 
be annulled, as they serve to demonstrate that the Prince 
who had discretion and authority to enact them, wanted 
power to enforce obedience," to which may be added the 
remark of the learned Archbishop Leighton, that " too many 
rules may as much confuse a matter as too few, and do 
many times perplex the mind and multiply doubts, as many 
laws multiply pleading." 

2 p 



202 ON THE PREVENTION 

was infected ; and as the expedients which 
these documents recommend, for suppressing 
the contagion, offer a striking contrast to the 
energetic measures which it was afterwards 
found necessary to adopt, and which proved 
so speedily successful, the mistakes that led 
to the spread of the disease will be placed in 
a more conspicuous light than could be done 
by more general statements. 

I refer these orders to three periods— 
the first commencing from the announce- 
ment of the first suspicious case of Plague 
in Valetta, until the specific nature of the 
disease was unequivocally declared ■ — the 
second, from the period of this declara- 
tion to the appointment of an effective Po- 
lice — and the last, from the appointment of 
the Police until the extermination of the dis- 
ease in Valetta. 

It would have been proper to include 
under a separate consideration such orders as 
may have been issued for protecting the public 
from the consequences of th€ infected vessel 



OF THE PLAGUE. 



203 



lying so near to the city ; * but if any spe- 

* By permitting the vessel to anchor there, the fate of the 
island was surrendered to the mercy of those persons, already 
mentioned under the name of guardians, and who, from the 
smallness of their salary, were exposed to many temptations 
to violate their trust, or to be negligent in the performance 
of their duty. The following fact, related to me by the 
mate of a merchant vessel, whose veracity I had every 
good reason to be satisfied of, will mark in a striking manner 
the vigilance of those guardians of public health, The trans- 
action was stated to have taken place during the month pre- 
ceding the arrival of the San Nicolo, and whilst the Plague 
was raging in the Levant. This man having happened to 
pass in a boat near to a Smyrna ship under quarantine, was 
recognised by the master of the vessel, an old acquaint- 
ance, who, hailing, pressed him to come on board. But 
he declined so doing, considering that his compliance would 
amount to a very wanton violation of the Health Laws, upon 
which the other threw a basket of figs into the boat, ex- 
claiming jocosely, " you are in for it now as well as myself," 
meaning that he was equally subject as himself to be detained 
in quarantine. Still, however, failing to prevail over his 
objections to come on board, the Smyrna captain waited an 
opportunity while the boat lay along-side, and actually 
leaped into it, soon after which his friend returned to Va« 
letta, and mixed as usual with the people. 

If any doubts existed as to the right of burning or other- 
wise destroying the Plague ship, St. Paul's Bay was open 
for her reception, or if the fitness of this bay was not known, 



204 ON THE PREVENTION 



cial directions were given on this subject, 
they were not known to me. 

The first announcement of a suspicious 

there remained another alternative which would not have 
been less efficacious in extinguishing the contagion, I mean 
that process which is termed by sailors, " Swifting" aud 
which is performed by passing cables round the ship's bot- 
tom; and sinking her in such a manner as to allow of her 
being raised again. As the cargo consisted principally of 
bale goods, a few days immersion would not have materially 
damaged the bales, and there were many instances that 
might have been pleaded as precedents for the measure. 
The same means were used with a Spanish frigate in the time 
of the grand Master Rohan, when the disease was smo- 
thered at once, without passing the walls of the Lazaretto. 
Our late prime minister, likewise, made no scruple of treat- 
ing suspected vessels in the same summary way, pleading 
for his justification the simple but substantial precept of 
salus populi suprema lex. By the Government Journal of 
Malta, it appears that any vessel that may arrive in future 
under the same unfortunate circumstances as the San Nlcolo 
will be very promptly disposed of. The terms of the Journal 
are as follow, published under the authority of the present 
governor. 

" When on the arrival of any vessel it may appear that 
the Plague actually rages on board, such vessel will be re- 
fused admittance or burnt with her cargo, as circumstances 
may require," 



OF THE PLAGUE. 



205 



case of Plague in Valetta is dated the 5th of 
May, and was accompanied with the follow- 
ing observations and instructions : " The King's 
Civil Commissioner having been apprised by 
the Board of Health that two individuals, who 
resided at No. 277 in Strada San Paola in this 
city had, during the existence of a malady 
with which they were attacked, and which 
terminated fatally to both, exhibited symp- 
toms strongly indicative of the Plague, and 
that another individual of the same family 
had been seized with similar symptoms, His 
Excellency deems it essentially necessary, 
with a view to the preservation of the public 
health, that besides the removal to the La- 
zaretto of the sick persons, and of those who 
had more immediately communicated with 
the family, the following measures of pre- 
caution and other suggestions of the Board 
of Health should be carried into effect. 

" I. That an embargo be continued on the 
shipping in the Port during the present state 
of suspense and anxiety. 

" II. That in the view of more effectually 



206 ON THE PREVENTION 

securing the health of the community, until 
it can be ascertained whether the malady ap- 
prehended does really exist, the Courts of Ju- 
dicature, the Theatre, and other places of 
public resort, be for the present closed, and 
that during this interval the operations of the 
respective offices of Government be limited 
to such transactions only as the indispensable 
exigencies of the public may be found to 
require. 

"III. That the various quarters of the city, 
including all the towns within the forti- 
fications, be placed under the immediate 
inspection of medical persons, who, aided by 
other respectable inhabitants, shall daily 
visit the districts respectively allotted to 
them, and report their remarks for the in- 
formation of the Board of Health. 

" In regard to the farther regulations to be 
observed, thev shall from time to time be 
promulgated by the magistrates of Police, or 
otherwise, as occasion may require/' His 
Excellency then goes on to recite a passage 
from a report of the Board of Health, an- 



OF THE PLAGUE. 



207 



nouncing that " the city is free from any 
contagious malady, excepting only the family 
of Salvatore Borg, (then in the Lazaretto), 
respecting which the Board sees no reason for 
diminishing the suspicions it has enter- 
tained." 

In a notice of date the 7th of May, the 
Board states that several persons are affected 
with suspicious symptoms ; one of these 
" la di cui malattia fortemente credesi 
" essere pestilenziale" — another exhibiting 
after death " alcuni segni indicanti la peste." 
The cautionary measures directed are, that the 
superintendents of the different districts of 
Valetta shall punctually make their reports 
of the state of the public health, and punish 
(indefinitely) such as are disobedient to their 
orders. 

On the 10th it is directed that the general 
purification of houses shall commence by 
washing with soap and water, whitewashing, 
scouring, and cleansing with salt water,. -de- 
stroying old clothes, rags, &.c. &c. Sec-. 

On the 12th a perfectly favourable report 



208 



OX THE PREVENTION" 



is given of the public health ; but it is stated^ 
that in consequence of the appearances on 
the body of Salvatore Borg, the College of 
Physicians have characterized the disease a 
contagious pestilential fever, adding, that the 
Board of Health recommend an attention to 
the same precautions as before, as necessary 
in the present doubtful state of things. It is 
also recommended that people should remain 
in their houses, and avoid touching any 
person or thing that might convey infection, 
some instructions being added on the safest 
mode of buying provisions and necessaries, 
after which the article concludes with ob- 
serving :— " The chief of every family who 
wishes to adopt these precautions must an- 
nounce his intention to his dependents, who 
not consenting to conform thereto, under ap- 
prehension of the rigorous punishments pre- 
scribed for the violation of the Quarantine 
Laws, shall be allowed to quit the house. 
This precious document is signed by the 
President of the Board of Health. 

On the 18th the Board observe it would 



OF THE PLAGUE. 



209 



be desirable that boys should not continue to 
run about the streets defeating the precau- 
tions ; and it is represented that the College 
of Physicians are confirmed in their opinion 
that Salvatore Borg's disease is contagious 
and pestilential. 

A notice of the 14th expresses surprise 
that so many persons are neglectful of pre- 
cautions. 

In another of the loth, the island is again 
represented to be in a perfectly favourable 
state, " no case having occurred worthy of 
remark " It is however, deemed necessary 
to order fines to be levied for offences against 
public orders. 

On the 17th, the Goverment, after ob- 
serving that many persons had concealed 
their illness, offer a reward for their disco- 
very, and for the first time denounce 
death against such as are convicted of rob- 
bing and pilfering from infected houses, and 
prohibit the meeting of public and private 
schools. On the same day, after announcing 
that the malady had begun to make farther 
2 E 



210 



ON THE PREVENTION 



progress, the Board of Health observe that 
the gates of the city have been closed against 
all persons who have no business in Valetta. 

On the 19th a census of the inhabitants is 
directed,— their names to be affixed to the 
doors, — and the people to shew themselves at 
their windows when required so to do by the 
superintendents of districts, on pain of fine 
or corporal punishment. 

On the 24th there are some severe ani- 
madversions made on the conduct of such 
as endeavour to propagate the opinion that 
the prevailing disease is not the Plague, and 
the government directs that the decisive opi- 
nion of the College of Physicians he published 
for general information. Accordingly, the 
physicians report, that having seen various 
individuals afflicted with the prevailing malady 
within the last few days, they are more de- 
cidedly confirmed in their opinion, that it is 
the true Plague, and express surprise that the 
people should have had any doubts on the sub- 
ject. 

The reader will bear in mind, that from 



OF THE PLAGUE. 211 

the date of the illness of Borg's first infected 
child up to this public decisive declaration of 
the nature of the disease, more than five 
weeks had elapsed. 

I shall next notice certain orders and ar- 
rangements between this period, and the 
appointment of an effective Police. 

On the 29th of May Government observ- 
ing a general disregard of precautions, or- 
dains, on pain of a breach of the quarantine 
laws, that no person shall change his place 
of residence. 

On the 3d of June, the disease gaining 
ground rapidly, it is commanded that there 
shall be a temporary suspension of social 
and commercial intercourse, as pro- 
mising the only chance of arresting the 
contagion ; and a hope is expressed that the 
public will have good sense enough to yield a 
ready obedience — any refractory person to be 
arrested, or even a whole family to be put in 
quarantine in their own houses if disobedient, 
to orders! To secure a more exact com- 



212 ON THE PREVENTION 



pliance, Valetta is divided by barriers 
* into districts, and all commercial business, 
with the exception of certain licensed shops, 
suspended. 

On the 29th a new Council of Health is 
constituted under the title of an " extra- 
ordinary council." 

I come now to the last division of official 
instructions, and to which Malta is immedi- 
ately indebted for its preservation. 

On the 3d of July orders are issued for 
raising an effective Police, upon which the en- 
forcement of all regulations is now stated es- 
sentially to depend. An Inspector-General is 
appointed at the head of the Police, and is 
invested with full powers of checking every 
kind of disorderly conduct and disobedience 
of orders. The measures of this officer 
were seclusion and segregation, and almost 

* For a considerable time after these barriers were erected 
the people paid no regard to the recommendation of remain- 
ing in their dwellings ; and in consequence the barriers, in- 
stead of preventing, greatly promoted their congregation in 
the streets. 



OF THE PLAGUE. 



213 



identically the same as were recommended 
by myself on the first moment of a report 
of the Plague in Valetta *. These means, 

* These measures were stated in a letter to the Board of 
Health on the 5th of May, and immediately after the report 
of the first suspected case in Valetta. As it would take 
up too much room to transcribe the communication at ful' 
'ength, I shall content myself with merely giving the heads 
of my proposals for checking the farther progress of the con- 
tagion, and which were as follows : the proper provisioning 
a nd appointment of the Lazaretto- the selection of the most 
trust-worthy persons for the service of the Lazaretto, their 
wages being raised to invite a sufficient number— the employ- 
ment of the troops as guardians — the universal shutting up 
and provisioning the people in their own houses, excepting 
such as were engaged in the public service — the appointment 
of patroles in the streets and highways, with authority to pre- 
vent every kind of intercourse among the people by the 
sword, if necessary — a census of the inhabitants and the 
obliging them to shew themselves at stated times at their 
doors or windows for inspection, in order to the immediate 
detection of the disease — the segregation, insulation, and 
provisioning of the poor— burning or purifying of goods be- 
longing to the sick— the confinement of animals liable to 
transfuse the contagion— the exclusion of all vessels from 
entering any of the Ports of Malta — the prevention of com- 
munication between the vessels in the harbour— finally, these 
rules to be proclaimed and enforced without any respect to 
persons.— The letter concluded with the following re- 
flections, '* I cannot conclude without expressing my 



214 



ON THE PREVENTION 



were in a very short time followed by the 
most visible success ; and so early as the 
17th of this month it is proclaimed that 
the contagion has already begun to receive a 
decided check. On the 1st of August it is 
ordained that any person who shall change 
his place of residence is to be punished with 
death, unless he shall have obtained per- 
mission from proper authority ; the same 
punishment to be inflicted on those who 
conceal their illness — receive any article out 
of an infected house, or connive at others so 
doing. The people are all absolutely shut 
up * in their houses, with the exception only 

heartfelt regret at the delay with which some of these 
measures have been kept back,— while we are deliberating 
and discussing, all means may prove ineffectual, as hap- 
pened before, under similar circumstances, in this very 
island. On an emergency so frightful as the present, I can- 
not help most cordially concurring with the sentiments of an 
able writer : " in si gravi pericoli, e in tanta necessita, 
di conservare il popolo, chi governa, si potra ben pentire di 
n on aver fatto assai, ma non mai d' aver fatto troppo. Un 
solo peccato d' indulgenza, puo portare 1' eccidio a un pubb- 
iico tutto." 

* When the Inspector-General first proposed this mea- 



OF THE PLAGUE. 



215 



of the government officers — no one being per- 
mitted in the streets under pain of capital pu- 
nishment. The same measures are extended 
to the casals. Provisions, and necessaries of 
every kind, are carried to the houses of 
the inhabitants, and no shops allowed to be 
open. In short, the people are now placed 
in complete quarantine ; and to intimidate 
the refractory, a Maltese, of the name of 
Antonio Borg, (a luckless name, it will be 
allowed), who was detected concealing his 
illness whilst labouring under pestilential 
symptoms, is publicly made an example 
of and shot. From this time until the 
contagion was completely eradicated in Va- 
letta, the orders of Government are simplv 
confined to such details only as were es- 
sential to carry into effect measures of 
segregation, seclusion, and expurgation, if I 
except some instructions to prevent persons 

sure, it was thought impracticable. To prove the reverse, 
he made the experiment in a single district of Valetta, which 
succeeded so speedily, that the whole city was immediately 
placed under the same restrictions. 



216 ON THE PREVENTION 

going on board of ship * before performing 
quarantine of observation. 

A code of Health Laws, in spirit similar to 
those which proved so efficacious on this oc- 
casion, are, I understand, framed by the pre- 
sent Governor, and in readiness to be acted 
upon at the shortest notice ; and as His Ex- 
cellency has already been conspicuously dis- 
tinguished for suppressing the Plague within 
the space of two or three years, not less than 
three different times *f, the Maltese derive 

* Since the greater part of this work was printed, I find 
it stated in a public notice, dated the 4th of December, 1813, 
that no real case of Plague was communicated to any 
vessels in the harbour from the commencement. If this be 
the true state of the fact, it adds one proof more to those 
which have been produced, that the disease could not have 
sprung from any specific constitution of the air. The state- 
ment, however, is at direct variance with the earlier reports 
of the public health, alluded to in the former part of this 
volume. 

f " This is the third Plague," says Dr. Granville, " which 
Lieut-Gen. Sir Thomas Maitland has succeeded in com- 
pletely stopping and in preventing its propagation while com- 
manding in the Mediterranean. ,, — " The plan of insulation 
which Sir Thomas has adopted, founded on the firm convic- 



OF THE PLAGUE. 



217 



every satisfactory assurance of the sufficiency 
of the provision he has left for their security 

tion of the validity of the doctrine of contagion is so ad- 
mirably conceived, that were the Plague to be imported 
again into Malta, in less than a week every district* street, 
and house in that town would be respectively insulated, 
so as to place each individual beyond the contact of every 
other." (See the Doctor's letter to the President of the 
Board of Trade, A. D. 1819.) 

It is on record, likewise, that Malta, between the years 
1519 and 1675, was, by vigilant measures, protected from 
Plague on four several occasions And I hold it as not less 
due to the efficacy of a similar provision, that Sicily con- 
tinued in security throughout the whole period of the suffer- 
ings of Malta in 1 813. From the first moment that the state 
of the latter island was known, the Sicilian government de- 
termined inflexibly to allow of no intercourse between it and 
their own shores, excepting on terms of the most rigid re- 
striction : in proof of which I may mention a circumstance 
that was told me by an English nobleman who happened to 
be on his travels in Sicily at that period. Thinking it very 
unaccountable that a country so contiguous to Malta should 
not have shared the same fate, he made particular enquiry 
into the cause of so singular an exemption, and was answered 
by his informant pointing to one of the numerous gibbets on 
the coast, emphatically exclaiming, " that, Sir, is our only 
defence." I have formerly observed that to enter into detail 
of the instances that might be cited in different countries to 
shew the efficacy of restrictive measures, would be incon- 

2 F 



218 



ON THE 



PREVENTION 



in future. Seeing that the contagion is thus 
under control, what a sad display of mis- 
management on the part of the Government 
and Health Department of Malta have we 
not before us in the preceding details ! The 
best lesson that can be derived from such 
unhappy occurrences, is the impressing the 
conviction that the most prompt and decided 

sistent with my purpose. I will beg to notice, however, 
one single example more, as it is one of the most convincing 
and remarkable ; I allude to the long escape of the popu- 
lous and commercial city of Marseilles. If the reader 
be desirous of obtaining particular information concerning 
the quarantine system in force at this place, he will be 
gratified by perusing a work entitled Dictionaire universelle 
de Commerce dedie a la Banque de France, in which the 
author breaks forth into the following exclamation, after re- 
marking upon the excellence of its quarantine system — 
" combien des fois n' a t'elle pas ete enferme (la peste) dans 
cette enceint du Lazaret ! combien des fois ne le sera 
telle pas encore ! cependant lout le monde Tignore. 
chacun dort dans uue parfaite securite." It is needless to 
add, that there never was any part of the world more fright- 
fully visited by pestilence than Marseilles in former times, 
even when its commercial intercourse was not so extensive 
by much as it is at the present day; and, perhaps, there is 
no place more openly and perpetually exposed to import 
the contagion than it has continued at all times. 



OF THE PLAGUE. 



219 



measures ought at once to be had recourse 
to, and that the greatest of all evils is to 
temporize. This was the opinion of the 
able writer* to whose sound precepts I 
have had occasion more than once to refer ? 
and whose concurrence with my own senti- 
ments is so impressively stated in the fol- 
lowing sentence :— " besogna persuaders! 
che diligense umane possono preservare, e 
preservano dal contagio i paesi, e per conse= 
guenza che il non usarle per quanto si puo, 
e a tempo, questo e un solenne e miserabile 
pazzia, o pure una negligenza difficilmente 
degna di perdono si presso agli uomini, come 
presso a Dio/' 



* Muratori 



220 



OBSERVATIONS ON THE 



CHAPTER VII. 

Observations on the symptoms, treatment, &c. of the Plague, 
as it lately occurred in Malta. 

The experience of the medical authorities 
employed during the late Plague of Malta, 
I regret to say, was productive of but little 
accession to our knowledge, in respect either 
to its rationale or treatment. That I may not, 
however, be chargeable with negligence, by 
omitting to notice a branch of my subject so 
important, I propose to devote this chapter 
to lay before the reader such notes*, as 
I was enabled to collect from my per- 
sonal observation, and the opportunities 

* The principal matter of the following observations being 
to be found in my paper in the Edinburgh Medical and Sur- 
gical Journal, I propose to confine myself as closely as I 
conveniently can to this document, only extending my re- 
flections upon such points as appear to me to have been rather 
hastily dismissed in that communication. 



SYMPTOMS, &C. OF THE PLAGUE. 221 



which occasionally occurred to me of com- 
municating with some of the most expe- 
rienced practitioners in the island. The re- 
marks, which I offer on my own authority, 
if found to possess few other recommenda- 
tions, will deserve, at least, to be considered 
as a faithful record of facts, the greater part 
of which were taken down before the first 
impressions were effaced, and many before 
leaving the wards of the pest-house : and, in 
respect to one remedy, the cold affusion, 
of which I believe I was the only person who 
made trial, I hope to bring forward some 
facts of a description to encourage a more 
extended application of its powers in cutting 
short the disease at its commencement. 



Symptoms. 

The Plague is a disease so eccentric as to 
present phenomena in variety and combina- 
tion almost unlimited, so that it may fairly be 
regarded as, at once, the most undefinable 
and most unmanageable of all ailments in- 



OBSERVATIONS ON THE 



cident to the human frame. Usually, how- 
ever, its approaches were marked by some of 
the following symptoms — head-ach, nausea, 
sudden prostration of strength, stupor, rigors, 
vertigo, vomiting of a vitiated bilious 
matter, pain of the back, sanguinous suffu- 
sion of the eyes, with a peculiar cast of 
them, which has beeo imperfectly attempted 
to be described by a certain writer * as of a 
" muddy dull colour". The pulse was very 
variable, but often rapid in the extreme ; 
indeed frequently so rapid as almost to defeat 
every attempt to reckon it, the pulsations suc- 
ceeding each other in a continued stream ra- 
ther than marked by any distant intervals. 
The tongue was usually white, sometimes 
streaked with red, or covered, as with a 
whitish pellicle, but I have observed it clean 
even in the most malignant disease. The 
bowels were frequently constricted, but more 
generally purged, and there was in the 
greater number of cases, a very distressing 

* Russel. — It was, doubtless, a similar appearance in the 
eye which Virgil meant to express by oculos stupor urget 
inertes. — Vide Georgics, 3d Book 



SYMPTOMS, &C. OF THE PLAGUE. L 2 25 



sense of oppression at the praecordia. Fewer 
or more of these symptoms marked the disease 
early after its accession, yet it was not uncom- 
mon for glandular and other tumors, with- 
out any apparent general disturbance of the 
system, to give the first alarm of its presence. 

It could not be foreseen that any pecu- 
liarity of constitution would confer security 
against its attack. 

The character of the fever which accom- 
panied the severer forms of the disease was 
very irregular, existing in every degree of 
inteusity from the most urgent synocha down 
to the lowest form of typhus, and in some 
instances having accessions of rigor at the 
commencement, not unlike an intermittent. 
These rigors, however, were not generally, as 
in intermittents, followed by heat and per- 
spiration, neither did they observe periodical 
times of recurrence. Thirst was not a con- 
stant symptom, even when the pulse was 
much accelerated, and when there existed 
every appearance of strong febrile action. 
The appetite was, in many instances^ not 



2M 



OBSERVATIONS ON THE 



only not impaired, but bordered on bulimia. 
This preternatural desire for food often ac- 
companied the convalescent stage. The 
alvine dejections were very variable — but in 
general attended with copious discharges 
of a very foetid bilious matter, or passed in 
scybala. Worms of the round species were 
voided not unfrequently, and their expul- 
sion was always a very hopeless symptom. 
It is remarkable, that on the first seizure 
several patients were unconscious of their 
state, and would insist upon being perfectly 
well, though there was, at the same time, 
something so characteristic in the eye and 
features, that a very little experience was 
necessary to enable the most common ob- 
server to see distinctly the actual state of 
the patient, and to discover that this as- 
surance was mere self-delusion. 

The suddenness with which the Plague 
makes its attack is very remarkable, many 
being apparently in the full enjoyment of 
health but a few hours before death. The 
duration of the disease is not less remarkably 



SYMPTOMS, &C. OF THE PLAGUE. 225 

inconstant; and, although it terminated in 
many cases so very suddenly, it was in others 
protracted to the end of the second or the 
third week before the fatal conclusion. In 
some, after every appearance of danger was 
surmounted, a phthisis or dropsy supervened, 
and proved fatal. Seldom, however, above 
seven days elapsed until the event was deter- 
mined, and in the greater number of cases the 
scene was closed in three, yet many, though 
having large tumors in the groin or axillae, 
continued able to walk about the streets, and 
in a few days were restored to perfect health. 
It was not unusual for glandular swellings to 
shew themselves only a very short time before 
death, and in several cases after this event, 
they subsided entirely out of sight, when livid 
spots, or petechia, about as large as a silver 
penny were discovered upon the breast, 
arms, wrists, back, and lower extremities. In 
a few, these spots did not make their appear- 
ance until the body was quite cold, in others, 
they accompanied the disease throughout. 
The carbuncles which came under my own 
2 G 



226 OBSERVATIONS ON THE 



observation were of that description men- 
tioned by authors under the denomination of 
the wet carbuncle, sloughing into deep ulcers, 
and attended during their progress to sup- 
puration with an intensely painful sense of 
burning. At first they arose as a com- 
mon phlegmon, gradually acquiring a dif- 
fused and highly inflamed base, and not far 
from the apex, having a concentric areola of 
a deep livid, and more internally near to the 
summit, of a cineritious colour, with a glossy 
appearance. These eruptions were not con- 
fined to any particular part of the body. 

Of the dry carbuncle, or that kind which 
is produced by the confluence of those minor 
tumefactions, called blains, I have not had 
experience in my own practice. They be- 
tokened a very unfavorable termination. 

These various forms of the disease seemed to 
me to admit of being comprised under three 
general classes — the first in which the im- 
pairment of the energies of the brain and 
nervous system was the most conspicuous 
feature—in the second , the state of the brain 



SYMPTOMS, &C. OF THE PLAGUE. 



227 



was the very reverse, and the symptoms de- 
noted a high degree of excitement— the last 
presented symptoms not unlike in character 
to those of the second class, but much milder, 
and attended with no apparent fever. 

In the first, the characteristic cast of eye 
and countenance were peculiarly striking 
— the stomach very irritable— debility ex- 
treme — and carbuncles made their appear- 
ance early. When this form of the dis- 
ease was accompanied with parotid swel- 
lings, it presented no hope ; and, according 
to the most probable calculation, the propor- 
tion of recoveries did not exceed ten in a 
hundred. Cases of this description were 
chiefly prevalent after the contagion began 
to commit its first ravages. 

In the second class the pain of the head 
was intense, thirst sometimes urgent, coun- 
tenance flushed and utterance hurried. The 
glandular swellings came out slowly, and, 
after appearing, receded with an aggrava- 
tion of all the symptoms. The carbuncles 
became soon gangrenous, and the delirium 



228 



OBSERVATIONS ON THE 



often resembled the ferocity of a maniac. 
This description of the disease was nearly 
as destructive as the former. 

In the last class all the symptoms, as al- 
ready observed, were, comparatively, very 
mild — and the glandular tumors proceeded 
on gradually and kindly to suppuration. This 
is the form of Plague to which I have alluded 
as affecting those who were found walking 
about the streets, apparently in health. The 
average deaths were computed not to exceed 
sixty in a hundred. 

It might be taken as a general rule, that 
the less severely the brain participated in 
the general derangement, and the more re- 
mote the symptoms from indicating debility, 
the prognosis was proportionally encouraging. 
Still it was not unusual to find, after several 
days of apparent convalescence, that sudden 
death surprised us in the midst of our hopes. 
When glandular tumors came out tardily, or 
remained stationary, the result was in the 
greater number of instances unfortunate, 
and the nearer any kind of tumors or erup- 



SYMPTOMS, &C OF THE PLAGUE. 229 



tions were seated to the head, the danger 
became the more imminent. 

From the state of the urine little could be 
collected, nor did it seem to be materially 
influenced by the vicissitudes of the disorder. 

A generally diffused moisture over the 
surface was among the most auspicious signs 
of amendment. 

Diarrhaea, when violent, never failed to 
produce a fatal issue. 

After the enumeration of the foregoing 
symptoms — symptoms not less peculiar in 
their combination than character,- — -it would 
be trifling to set seriously about a formal diag- 
nosis. It has been alleged that the Plague is 
only a modification of remittent fever, whilst 
by others it is assimilated to typhus. But 
that a disease can properly belong to any 
particular class of fever, which frequently 
exists without any perceptible fever what- 
ever, is not a very intelligible mode of noso- 
logical classification. It is checked or ex- 
tinguished by a degree of heat which is 
not only compatible with, but altogether 



230 



OBSERVATIONS ON THE 



necessary for, the production of remittents, 
and it will not arise or scarcely exist at the 
reduced temperature wherein typhus is 
most prevalent : neither will typhus exist 
in the degree of heat at which the Plague 
has been known to be most actively dif- 
fused *. 

Prophylaxis *f\ 

After what has been anticipated (at p. 145 
et seq.) on the means of defending the body 
from contagion, it remains for me only to add 
a few observations regarding the articles of oil 
friction and vaccination, which I could not 
notice before without making too long a di- 
gression from the subject more immediately 
under consideration. 

* The truth of this will appear by referring to the history 
of (he Plague, as it formerly prevailed in Loudon. 

t It will be observed in my observations on the Plague 
inserted in the Edinburgh Medical and Surgical Journal, that 
I was disposed to place no reliance on any means of pre- 
vention. However, at the time of transmitting that com- 
munication, I was still engaged in my enquiries into the 
subject, and had as yet not sufficient data upon which to 
ground a decided opinion. 



SYMPTOMS, &C. OF THE PLAGUE. 281 

Notwithstanding the extravagant terms in 
which oil has for some time been extolled for 
its preventive powers, there was a super- 
abundance of proof in Malta that it is by 
no means entitled to so high a character. 
The facts upon which this opinion is founded, 
are not limited to my own observation only, 
but confirmed by the experience of every 
intelligent observer from whom I could 
obtain any satisfactory information. The 
greater number of the Sicilians who came 
to Malta for employment in the service of 
the sick, perished, although in the daily 
practice of inunction before engaging in their 
perilous duties. A gentleman who superin- 
tended the health of one of the districts 
of Valetta assured me, that although 
he had constant opportunities of seeing oil 
frictions used by those under his immediate 
orders, he was satisfied that it was not merely 
useless as a defence, but even hurtful to the 
general health, by the debility which suc- 
ceeded to the profuse perspirations which 
it occasioned. Several instances occurred 



232 



OBSERVATIONS ON THE 



in the Third Garrison Battalion of persons 
being attacked, though obliged to use oil 
frictions with all the punctuality of military 
discipline. In short, there were so many in- 
stances of persons living in the closest in- 
tercourse with the infected who escaped 
without the use of oil, and so few well attest- 
ed cases of persons having come into ac- 
tual contact with pestiferous matter who 
were protected by oil alone, that I cannot he- 
sitate to conclude that the opinion * of its 
possessing any independent or certain pro- 
phylactic efficacy is destitute of foundation. 

I have dwelt the longer on the article of 
oil friction, as I deem it of importance that 
the credulity of mankind be not imposed 
upon to place reliance on any doubtful 

* This opinion has obtained currency of late years parti- 
cularly under sanction of Mr. Baldwin, Consul-General of 
Egypt : but when we reflect upon the length of time which has 
intervened since inunction w r as recommended by that gentle- 
man, and take into the account the destruction which the 
Plague has since continued to spread throughout Europe, it 
will be allowed that mankind have as yet had no great en- 
couragement to place faith in its defensive properties. 



SYMPTOMS, &C. OP THE PLAGUE, 233 

means of protection to the neglect of others 
much more deserving of confidence, such as 
have before been particularly detailed. 

Vaccination, as far as I could learn, was 
not recurred to with the express view of a 
preservative, but as it had obtained some 
repute for protective virtues, I took pains to 
ascertain whether those who had recently 
been vaccinated were rendered less sus- 
ceptible, and I found that the instances of 
its inefhcacy were every where numerous, 
of which I may mention rather a striking 
one, which was communicated to me bv a 
Maltese surgeon who was much emploved in 
the Plague, namely, that of a numerous fa- 
mily who had been recently vaccinated, the 
whole fell sacrifice- to the prevailing conta- 
gion, with the exception of the parents, who 
had never undergone the operation. 

As the penalty for feeling the pulse of an 
infected person, even through a tobacco-leaf, 
and with every possible caution, was not less 
than fifteen or twenty days close quaran- 
tine, the privilege of inoculating with Plague 
2 H 



234 



OBSERVATIONS ON THE 



matter was, of course, precluded * to all who 
were engaged in the public service ; arid I 
am not aware that any private practitioner, 
or other person, was ever led to rnake the 
experiment, neither, indeed, was there much 
to expect from it, if any reliance can be 
placed on the reports of those who have put 
it to the test. 

Treatment. 

Finding that the limits prescribed to thi s 
publication will not allow me to enter into a 
minute statement of the effect of every re- 
medy to which recourse was had on this oc- 
casion, I must content myself with a brief 
notice of such only as acquired the most 
popularity. 

In a disease of so multiform a character, 
it was impossible to regulate the treatment 

* It was more particularly to be regretted that we could 
not avail ourselves of the information to be derived from 
morbid dissections, especially as there seemed to b'e good 
grounds for believing that after death the bodies wholly lose 
the power of giving out contagion. 



symptoms, &c. or Tin: V LAG U E. 235 



by any thing like system ; and we were, 
therefore, obliged to confine our practice to 
meeting the most urgent symptoms on ge- 
neral principles, borrowed from analogy. 
In my own practice I adopted two principal 
indications, namely, 

I. To moderate the symptoms denoting 
increased action of the arterial system, and 
especially those which marked considerable 
congestion in the brain. 

II. To sustain the powers of life when ex- 
hausted, and thereby to counteract putres- 
cency. 

With the first intention I employed bleed- 
ing, emetics, laxatives, sudorifics, refri- 
gerants, and blisters ; and with the second, 
tonics, and cordials. 

Although I failed to ascertain, during 
my residence in Malta, that the natives had 
made any trial of venesection, I found, on 
my return to England, in a paper inserted 
in the Edinburgh Medical Journal by Mr. 
Stafford, who served as Surgeon to the Third 
Garrison Battalion in the PJague, that he 



236 



OBSERVATIONS ON THE 



became averse to bleeding in consequence of 
being informed that the Maltese lost fifty-nine 
cases out of the first sixty in which they 
made the experiment. In my own practice 
I was contented with the local abstraction 
of blood by leeches applied to the temples, 
where the state of the brain appeared to 
call for active depletion. It seemed, how- 
ever, very doubtful whether any benefit 
was secured by it, or rather that some 
positive mischief might not have been done 
by favoring the debility, to which there 
was so marked a pre-disposition, and from 
the excess of which inducing a state of 
putrescency, the chief danger was to be 
apprehended. I was assured by one of my 
hospital-assistants, that in a few cases of 
blood being taken from the arm by himself, 
it threw up a bufTy coat, and the patients 
did well — by others, that the blood taken 
in this way exhibited a very dissolved state, 
yet the cases proceeded not less favorably. 
Amidst such conflicting testimonies it was 
impossible to get at a clear opinion. In re« 



SYMPTOMS, &G. OF THE PLAGUE. 237 



spect to the Maltese, although they may have 
deemed it expedient to make trial of blood- 
letting, I know that the practice was gene- 
rally regarded by them with much suspicion, 
Let me not, however, be understood to 
mean that bleeding is absolutely, and in 
all cases, hurtful ; so far otherwise, the very 
discrepancy which exists among writers in 
regard to it, is, in my judgment, rather some 
proof that there may be instances in which, if 
resorted to under fit circumstances, it might 
prove eminently beneficial. But it is obvious 
that the success of any remedy in a disorder 
of so various a character, and which runs its 
course so rapidly, must essentially depend 
upon a variety of circumstances and contin- 
gencies peculiar to each case, and particularly 
the stage of the symptoms when it is re- 
ceived under treatment. In short, I conceive 
that the benefit which, according to the ge- 
neral consent of the highest authorities, is 
derived from blood-letting in other diseases, 
where a highly excited state of the brain is 
indicated, fully authorizes the opinion, that it 



238 



OBSERVATIONS ON TliJ£ 



might, with careful discrimination, produce 
not less beneficial effects in the Plague. 

Emetics were considered of service ad- 
ministered at the very first approach of the 
symptoms ; at a later period, or when in a 
vigorous and full habit, there was evidence of 
much fulness of the vessels of the head, they 
were thought to be dangerous. It was not 
unreasonable to expect from the shock they 
give to the nervous system, their efficacy in 
relieving congestions of the viscera, and espe- 
cially in promoting perspiration by determining 
to the extreme vessels, that considerable be- 
nefit might have succeeded to their exhi- 
btion ; but they certainly were in no instance 
found to produce the same visible good eff ect 
as is usually experienced from their operation 
in diseases of a purely febrile character. 

In my own practice, and generally, I be- 
lieve, among my medical brethren in the 
army, calomel and jalap were the aperients 
most commonly in use. The Maltese pre- 
ferred those of the mildest kind, such as 
cream of tartar, manna, and almond oil. 



SYMPTOMS, &C. OF THE PLAGUE. c 239 



the last being particularly esteemed on ac- 
count of its gentle operations. A purgative, 
properly so called, they seldom administered, 
excepting when the bowels were obstinately 
constricted, in which case the Epsom or 
English salt, as they termed it, had the pre- 
ference. This great caution in the use of 
purgatives was dictated by a dread of ex- 
citing diarhaea ; and as it was always so 
very difficult to regulate the quantity of the 
evacuation, their scruples were, perhaps, jus- 
tifiable in some measure, although it cannot 
be doubted that to allow corrupted humors 
or hardened faeces to remain irritating the 
intestines was a state of things not less 
warily to be guarded against. 

The sudorifics most in estimation with 
the Maltese were the spiritus Mindereri and 
theriaca Andromache, aided by elder flower, 
which is a very favorite nostrum among the 
Turks *. These medicines were given with a 

* Elder flower tea is looked upon as a kind of specific 
in the Levant, and was brought into great repute among the 
Maltese by a Jew quack, who, with all the confidence of his 
calling, engaged to cure the very worst cases of Plague, pro- 



240 



OBSERVATIONS ON THE 



liberal hand in every form and stage of the 
disorder, as appeared by the treatment 
pursued in the Lazaretto, on the outside of 
which there was suspended a board -j*, having 

vided he were well paid for his trouble, and the symptoms 
not too far advanced. — The latter condition of the agreement 
proving a very convenient subterfuge for his failures, whilst 
the first secured him a winning game at all events, this son 
of Apollo continued to dupe the unhappy people for a length 
of time, until the tide running at length very strong against 
the popularity of his specific, he found it expedient to make 
rather a hasty retreat from the scene of his operations, and 
leave the island. 

f A British civilian practitioner, resident in Malta, who was 
tempted to visit this scene of suffering and wretchedness as 
well as myself, with the view of obtaining some knowledge 
of the Maltese practice, told me that he found both 
sexes lying in the torments of the disease in the same apart- 
ment, with no other covering than what they brought in on 
their backs. When I visited the Lazaretto myself there were 
twenty-eight cases under treatment, with only two individuals 
(convicts) to attend upon them, as nurses. Eight of these 
cases T particularly examined, of whom one had the femoral 
glands of one side in an incipient state of inflammation — 
another an axillary bubo, the third, fourth, and fifth, in- 
guinal buboes — the remaining three were already dead — two 
of the surviving five, apparently in health, but the whole 
perished in about thirty-six hours. With such attendance 
and accommodation it surely was not possible fairly to esti- 
mate either the destructiveness of the disease, or the efficiency 
of remedies. 



SYMPTOMS, &C, OF THE PLAGUE. 241 

on one side written in chalk, the medicine 
for the day, or spiritus Mindereri, and on 
the other, the theriaca, or medicine for the 
night, without any apparent regard to age, 
sex, or constitution ; and this routine seemed 
to be kept up with as much regularity as 
if Dr. Last had had the charge of the hos- 
pital committed to himself. 

James's powder acquired some character 
in our army for abating the extreme heat 
and dryness of the skin, but I had no expe- 
rience of it in my own practice, I was greatly 
disappointed in the effect of (that far-famed 
specific,) camphor, and, although administer- 
ed in every variety of dose, it failed to allay 
irritation, even in those cases where its soothing 
qualities promised to be most serviceable. I 
observed manifestly more composng effects 
from medicines of the refrigerant class, espe- 
cially nitre and cream of tartar, when assist- 
ed with lemonade or rice water. 

When the brain was much disturbed, 
blisters were applied to the nape of the neck, 
between the shoulders, or to the hinder or 

2 i 



242 OBSERVATIONS ON THE 



forepart of the head, and, in most instances, 
the advantage was apparent, although too 
often but temporary. 

Of the effect of antispasmodics I was not 
able to obtain any satisfactory report, ex- 
cepting of opium, which was accounted 
a precarious remedy ; more apt to excite 
than allay the irritability and restlessness, 
and in some cases it was represented as 
adding very considerably to the stupor. 

The tonics employed by the Maltese were 
calumbo, gentian, Peruvian bark, and ser- 
pentaria, and supposed to check the ad- 
vances of debility when administered at an 
early stage. Wine and cordials were given 
with the same intention. To the former I 
could myself ascribe decided good effects, 
particularly in relieving low delirium, and 
in supporting the sinking powers of life at 
an advanced period. I generally preferred 
giving it in sago. 

The treatment of the glandular swellings 
and carbuncles was comprised in emollient 
poultices, blistering, digestive applications, 



SYMPTOMS, &C. OF THE PLAGUE. C 24S 

and the actual and potential cautery. 
Poultices were of much use in abating the 
heat, pain, and tension, and after the car- 
buncles had arrived at a sloughing state, di- 
gestive ointment, especially if aided by sca- 
rification, was serviceable by promoting the 
separation of the dead from the living sub- 
stance. Blistering under the buboes was a 
favorite practice with the Maltese, and de- 
signed with a two-fold purpose, either to 
promote their retrocession or to expedite 
maturation, but with what success was 
very doubtful. When the cautery did not 
succeed speedily in promoting suppuration, 
it occasioned the tumors to recede with a 
manifest aggravation of all the other symp- 
toms. 

Mercury. 

The importance which has of late years 
been attributed to mercury for the cure 



2U 



OBSERVATIONS ON THE 



Plague, entitles it to a separate and 
more particular notice. Its internal exhi- 
bition was restricted to calomel. In the 
Maltese practice calomel was never given as 
a purgative, nor with any other view beside 
that of maturating buboes, for which pur- 
pose it was believed to be efficacious when 
employed along with mercurial frictions, or 
spread over poultices. 

Mr. Stafford, of whom I have before made 
mention, and who has favored the world 
with a very clear account of the effects he 
obtained from mercury, roundly states that 
he had, while his regiment was infected, 
thirty or forty cases of tumor in the axillae, 
which recovered under its use. In some of 
these the tumors suppurated, and in others 
they were absorbed. This gentleman narrates 
five cases at full length which were treated in 
the same manner, of whom three recovered. 
Two out of these three had their mouths 
made sore ; the fourth died before the remedy 
could be used, and the fifth perished, not- 



SYMPTOMS, &C OF THE PLAGUE. 245 



withstanding its use *. In my own practice 
calomel was given only as an adjunct to pur- 
gatives, and it therefore, perhaps, could not 
be expected to exert any of its supposed 
specific effects over the disease. 

* 1 conceive the importance of the information will justify 
my transcribing these cases from Mr. Stafford's paper. 

Case I. 

14th June 1813.— Jerry Wiseman, aged 32, spare 
habit of body, complains of head-ach, pain across the lum- 
bar region; has had slight rigours; eyes clear but dull, as 
though under the indirect influence of liquor ; tongue a pale 
chalky white, with a brown streak in the centre ; a tumour 
in the inferior gland of the groin, about the size of a walnut, 
with but little pain ; bowels regular. 
H Calom. pptt. gr. x. 
Jalap, gr. xv. 

Cons. q. s. ft. bol. statim sumend : 
And to rub in two drachms of mercurial ointment along the 
course of the absorbents. 

15th. — The bolus gave him several stools ; the bubo, and 
the other symptoms, the same as yesterday. The ointment 
was again rubbed in, and the bolus repeated this day. 

16th. — Eyes less dull; tongue clean and moist, with less 
of the chalky appearance ; has had plentiful evacuations by 



246 



OBSERVATIONS ON THE 



Cold Water. 

The last article of treatment which remains 
to be noticed is the application of cold water 
to the skin by affusion. 

stool ; tumour stationary. To continue the ointment. 
Ii Calom. gr. iij 
Pulv. Jacob, gr. v. 
Cons. q. s. ft. bol. cap. h. s. 
17th. — Tumour seems less ; tongue has lost the brown 
streak ; he seems more cheerful ; had a gentle moisture on 
the skin during the night, and slept well. The bolus and 
the ungt. hydr. to be repeated. 

18th. — Tumour less, mouth sore, tongue nearly of na- 
tural appearance. The ointment was omitted, but the bolus 
continued several days longer. The mouth was kept tender 
with calom. gr. i. night and morning, until the 28th. He 
was discharged to his duty on the 2d July. He has conti- 
nued in perfect health ever since. 

Case II. 

10th July 1813 — Robert Clark, aged about 24, spare 
habit, lively disposition. He had never been in the hospital 
in my recollection. Had mounted guard this morning, after 
a minute naked inspection, when not a suspicious spot was 
to be seen on his body or extremities. His feet and hands 



SYMPTOMS, &C. OF THE PLAGUE. 247 



There were but two cases in which I could 
venture to employ this remedy with any 

had been carefully washed. About noon, I was sent for to 
visit him, he having been taken suddenly lame while on 
sentry. On examining him, 1 found a small pimple in ap- 
pearance between the large and the next toe of the right foot. 
The pain he declared to be excessive, and likened it to a 
burning coal. While inspecting it, I could discover rising 
from it a red streak, which speedily ascended up the inside of 
the leg, and very soon afterwards a swelling took place in the 
inferior inguinal gland. He was immediately sent to the hos- 
pital. The foot was well washed in warm water, a cataplasm 
applied to it, and the whole ofthe inside of the leg was rubbed 
with ungt. hydr. without any regard to quantity, as long as 
he had strength to rub it in, and calom. and jalap, each 
gr, x. given him at the same time. On seeing him in the 
evening, the pain from the pimple was less, but still severe, 
with considerable pain in the groin. He had several stools. 
He seemed to have some fever, and apparent giddiness in 
the head, but did not complain of pain in it. 

On visiting him in the morning, I found the pimple had 
now the appearance of a small ill-conditioned ulcer. It was 
again cleansed, and the cataplasm applied. On washin g 
away the ointment to look at the absorbent, I found it con- 
siderably enlarged ; and, arming my finger with a little of 
the ungt. hydr. I traced it from the sore to the bubo. It 
no longer appeared charged with a red fluid, but had a 
yellowish look. The tumour was, at this time, the size of 



248 



OBSERVATIONS OX THE 



hope of advantage, and in one of them it 
was followed by decided and immediate 

a pigeon's egg. The ointment was again used in the same 
way, and the bolus repeated. This method was continued 
until the mouth became very sore. The ulcer soon healed, 
and the bubo gradually disappeared. He went to his duty 
on the 25th of August, and has continued well. His de- 
scription of the first attack was, that he was standing sentry 
on the top of the arch, through which was the only passage into 
the country; that a pest-cart had that instant passed through, 
heavily laden with dead bodies, from which proceeded a 
horrid smell ; that the attack was instantaneous, as though 
he had been shot. I was instantly sent for, and was with 
him in three minutes, my quarters being near his post. My 
opinion was, that, from some defect in his shoe, some pest- 
dust had got in, and was the true cause of his complaint. 
He mounted guard at seven o'clock in the morning, and 
had to march half a mile from the barracks to his post. 

I have often read, and been otherwise informed, that when 
the pest-tumour could be brought to suppurate, the result 
was frequently favourable. I had determined, if T found a 
tumour of this description that would not submit to the mer- 
curial inunction, with the calomel purges, &c. to throw in 
the bark and wine largely. 

Case III. 

Oct. 17th.— Albert Rotoski, a Pole, aged 35, spare 
habit of body, dark complexion, was this day plaeed in 



SYMPTOMS, &C\ OF THE PLAGUE. 24Q 



amendment. The patient was almost in- 
stantaneously relieved from the distress of a 

observation, complaining of slight pain in the head and back ; 
tongue clean and moist, but much of the chalky appearance ; 
eyes heavy, but clear; bowels regular; spirits much de- 
pressed ; a small tumour in the lower gland of the left thigh. 
He was immediately ordered the Cal. c. jalap, and the fol- 
lowing : 

It Cal. gr. iii. 

Pulv. ant. gr. 5. to be taken at bed-time ; and to 
rub one drachm of mercurial ointment along 
the course of the absorbents. 
18th. — Seems to have more fever; headach worse ; more 
vivacity in the eyes; has had several stools; had no 
moisture on the skin; has more thirst; tongue much whiter. 
A blister was applied between the shoulders ; the saline 
mixture given him frequently ; the bolus and ungt. repeated 
in the evening; and an emollient cataplasm to the bubo. 

19th. — The bubo a little larger; slept a little in the night ; 
had some moisture on the surface; the blister rose well ; 
seems to have less pain ; tongue the same as yesterday 
Ordered all the medicines to be continued. 

20th. — Symptoms all nearly the same as yesterday ; bubo 
stationary ; with a little more pain ; has had no stools the 
last 24 hours ; mouth not in the least sore. I he bolus Cal. 
c. jalap, was given instantly; and the bolus Cal. c. pulv. 
ant. and the ointment to be repeated in the evening. 

21st. — Nearly the same in every particular; bubo sta- 
tionary, with considerable pain ; has not had sufficient 

2 K 



250 



OBSERVATIONS ON THE 



dry heated skin, and there succeeded a co- 
pious diaphoresis with great abatement of 

stools from the bolus. Ordered him an ounce of Nat. vitr. 
On visiting him in the afternoon, found him considerably 
worse; great giddiness in the head, and apparent paralysis of 
every limb, but perfectly sensible, and answered correctly to 
all my questions. In attempting to go to the close stool, 
which was within two yards of him, he had fallen several 
times, had cut his head, and bruised his arms and shoulders 
very severely. Dr Calvert (to whose recollection of this 
case I beg leave to refer) saw him in this state. I asked his 
opinion as to giving him bark and wine, as I had long made 
up my mind to try it in such a case. He said, he " looked 
on the man as lost;" but desired me to try any thing I 
pleased to save him I instantly ordered a drachm of pulv. 
cinchon. to be taken every hour, and a pint best white wine 
to be taken during the evening, and Caiom. gr iii Pulv. 
Jacob, gr. v Opii pur .gr. iss. to be taken at bed-time. Dr. 
Calvert ordered that he should be moved to the pest-hospital 
in the morning, if alive. 

22d. — Infinitely better ; slept well during the night, with 
a gentle and general moisture on the skin; the bubo less pain- 
ful, and larger ; has completely lost his vertigo, and apparent 
paralysis. When the sick-cart came for him in the morn- 
ing, he insisted that the men that came with it should not 
touch him ; nor would he go into the cart, but declared he 
was able to walk, which he did up a very steep and rough 
hill, and down again, upwards of half a mile, to the boat, 



SYMPTOMS, 5iC. Of THE PLAGUE. 251 



restlessness and an inclination to sleep. His 
recovery was complete in a very few days. 

which conveyed him to the pest-hospital. I feel that, for 
the man and myself, it was very fortunate that Mr. Cloak 
a young man of great ability, and then first assistant-sur- 
geon to this battalion, was on duty at the hospital at that 
time. He knew my ideas of the disease, and my mode of 
treating this case. He was so kind as to continue the same 
plan. In a few days the bubo suppurated ; he opened it, 
the man perfectly recovered, and has been in good health 
ever since. 

It will probably be alleged against me, that 1 did not use 
the remedy in the last case with my usual boldness. My 
answer is, I was under critical inspection. 

It is the duty of every practitioner, in writing on such a 
disease, to record his failures as well as his successes; and, 
if he has been guilty of inattention, to record that likewise, 
as a beacon to himself and others. 

Case IV. 

July 22d— John Evans, aged about 30, spare habit of 
body, much addicted to liquor, always dirty and slovenly, 
for which reasons he was made a pioneer, to clean the bar- 
racks, carry burdens, go messages, &c. He was employed 
on this day to carry something to Boschetta, a distance of 
seven miles ; he returned in the evening very drunk, with 
two black eyes, and several bruises about the arms and 
shoulders. I found him in this state the next morning, 
sleeping among his comrades of the same description. 1 



252 OBSERVATIONS ON THE 



The affusion was employed about the second 
day of his attack, and under circumstances 

immediately placed him in observation, gave him an ounce of 
nat. vitriol, and inspected him morning and evening naked. 
Found no suspicious marks on the trunk or lower extre- 
mities. T gave him no other medicine. 

25th — On this day, the steward of the hospital came to 
inform me, that this man had a total suppression of urine ; 
that on his trying to pass it, on his hands and knees, (he, 
the steward) saw on the lumbar region a tumour, small at 
first, but rapidly increasing in size as he was looking at it. 
T lost no time (the distance was half a mile) in going to him, 
and found him dead. The tumour appeared to me to be a 
carbuncle of the most malignant kind. I ought to have 
supposed that extreme debility would come on from the fa- 
tigue of his long journey under a summer sun. ] ought to 
have known the debility that comes on after excessive 
drinking, perhaps spirituous liquors. I ought to have sup- 
posed he had been in contact with some pest person, it 
having at this time spread to every part of the island. In 
fact, I should not have waited to treat the disease, after it 
appeared in such a habit as his, there being not strength 
sufficient in the system to resist it one hour. 

Case V. 

Oct. 20th.— Edward Traynor, aged about 27, stout, 
well made ; had never been sick in my remembrance ; was 
placed in observation this day. J was informed that he had 



SYMPTOMS, &C. Of THE. PLAGUE. 253 

the most encouraging, certain features of the 
disease agreeing to the conditions, which in 
fevers would be considered peculiarly adapted 
to the practice. 

In the second case the affection of the 
brain was too violent, and the symptoms 
existed altogether in too advanced a stage to 
warrant but a very remote expectation that 

•lept on tbe battery, exposed to the night dews, two nights, 
with a common woman. He complains of severe headach, 
thirst, nausea, pain in the back; tongue white and dry 
This was not supposed to be a case of Plague, as the im- 
prudence of his conduct was sufficient to account for all the 
symptoms. I ordered him immediately into a warm bath, 
and to take an emetic while in it ; a blister between his 
shoulders, and Pulv. antim. gr. vi. Opii gr. i. to be taken 
at bed-time; mist, salin. very frequently; the bolus Cal. c. 
jal^p in the morning. 

21st, Sunrise. — Considerably worse; much wildness 
in the eyes, and slight inflammation, vertigo, and slight 
delirium ; tongue much whiter. Saw him again at twelve 
o'clock. The bolus had not operated to my satisfaction. 
Gave him an ounce of natron, vitr. ; saw him again in the 
evening, and found a tumour in the usual place in the 
groin. The bolus was repeated in the evening, and two 
drachms of ungt. hydr. rubbed as usual. The next morning 
he was much worse. Sent him to the pest-hospital; he 
died in the evening. 



254 OBSERVATIONS OX T LI E 

the remedy would succeed ; and as to the rest 
of the patients under my charge, with the 
exception of those already convalescent, 
they were so excessively exhausted, that I 
should have apprehended so sudden and 
powerful a shock might have extinguished 
any remaining sparks of life ; and accord- 
ingly in those cases it was not applied. 

The following striking instance of the good 
effects derivable from the application of 
cold water by immersion occurred in the 
Lazaretto. One of the patients labouring 
under a most unpromising disease, and in 
the furor of delirium ran out of his apart- 
ment, and precipitated himself into the sea. 
He was immediately taken out, and con- 
ducted back to his chamber ; but no sooner 
replaced, than he took an opportunity of re- 
peating the same rash act. To the unspeak- 
able surprise of all who had seen his de- 
plorable sufferings before the immersion, he 
became almost immediately convalescent, 
and recovered. This case, from the distinct 
account which I received of it, was not less 



SYMPTOMS, &C. OF THE PLAGUE. 255 



fitly adapted to the remedy than that of 
Daniel Boan, already related. 

These facts seem to me so very decided as 
to justify a fair presumption that the cold 
affusion*, if applied at the very commencement, 
in such forms of Plague as bear the nearest 
resemblance to the fevers in which its use has 
been found most successful, might prove a va- 
luable expedient in assisting to cut short their 
progress ; that is to say, when the heat of 
the body considerably exceeds the natural 
standard, either as indicated by the ther- 
mometer or the feelings of the patient, and 
when there is, at the same time, so great 
an increase in the force of the circu- 
lation as to warrant the expectation of a 
vigorous re-action. To those, therefore, who 

* I find it stated in Dr. Currie's observations on this re- 
medy, that he had communicated his notions on the pro- 
bable advantages to be derived from the cold affusion in the 
Plague to the benevolent Howard, and that it was the in- 
tention of the latter to have fully investigated its merits on 
his next visit to the East. But, unfortunately, he did not 
lire to effect his intention. 



256 



OBSERVATIONS 



ON THE 



may hereafter have proper opportunities, I 
cannot but recommend that this remedy 
should have a fair trial, especially as all 
other means have been of so little efficacy, 
and as this one appears particularly adapted 
to the treatment of a disease, the progress of 
which is so rapid, while, at the same time, 
it can be so easily and so readily employed. 

Whilst looking over the foregoing cases 
of Mr. Stafford's, previous to their being 
copied into this volume, I was so much im- 
pressed with the clearness and candour of 
his statements, that I own myself inclined to 
believe that mercury might, under proper 
direction, become a remedy of considerable 
power, if employed at the first accession of 
the symptoms. Nor is this opinion mate- 
rially weakened by the numerous failures 
recorded by other writers, as it seems to me 
probable that the remedy has seldom been 
tried under circumstances so peculiarly fa- 
vorable to its success, as under this gentle- 
man's care at Malta. It is, I will allow, not 
unlikely, that in some of the thirty or forty 



SYMPTOMS, &C. OF THE PLAGUE. £5? 

cases of axillary bubo which he alleges 
having cured by mercury, several might 
have arisen from external injuries or other 
ordinary causes, but it is not to be presumed 
that he should have been deceived in the 
character of them all, nor that swellings of 
this description should have been of so 
much more frequent occurrence whilst the 
regiment was infected, than at any former 
time, did they not proceed from the cause 
so universally prevalent. In whatever way 
Mr. Stafford's success is to be accounted 
for, we must, at least allow, that the facts 
which he has advanced are too important 
to be overlooked. 

In respect to some of the various remedies 
of which a report has been given, on the 
authority of the Maltese, I cannot help ex- 
pressing my belief, that the information com- 
municated to me was much more the result 
of their speculation than practice. Zealous 
as these gentlemen may have been to im- 
prove their opportunities of investigating 
what medicine could accomplish, there were 

2 L 



258 



OBSERVATIONS ON THE 



certainly few facilities afforded for applying 
their skill and talents with effect, as patients 
were not placed under their care, in the 
greater number of instances before the golden 
moments had passed for rendering them any 
successful assistance. And in a disease where 
the maxim " venienti occurrite morbo" ap- 
plies with such peculiar force, it is evident 
that this delay in sending patients into hos- 
pital, must have been completely fatal to the 
object of appreciating the efficacy of any 
remedies. 

For a more circumstantial account of the 
treatment adopted with the patients imme- 
diately under my own care, I must refer to 
the cases cited underneath, and which I copy 
from my note-book without commentary. 

Memorandums of Cases in the Military Pest Hospital, under 
charge of Dr. Faulkner, Physician to the Forces, A.D. 
1813. 

Daniel Boan, set. 22, a very stout man. Admitted 
into the pest-hospital, 4th July. Was taken ill on the 3d. 
Previous to removal out of his barracks, complained of 



SYMPTOMS, &C. OF THE PLAGUE. 259 



headach, and want of appetite: tongue white; some ap- 
pearance of inflammation below the inguinal glands, ort one 
thigh, attended with stiffness; sleeps ill; belly costive; 
pulse accelerated ; eyes suffused. Had an emetic of ipeca- 
cuanha and tartrite of antimony, before removal out of the 
barracks, and two drachms of theaq. am. acetat. every three 
hours, barley-water acidulated with lemon-juice for common 
drink, and a mixture of cream of tartar to open his bowels. 
The skin, which was hot and dry, was directed to be sponged 
with vinegar and water frequently. 

Die 5. — Bubo, (described above as inflammation be- 
low the inguinal glands) more painful; an appearance of 
great distress in his looks. 

Si venter non solvitur, hac nocte habeat pulv. rhab. gr. 
xx. et calom. gr. iv. Perstet in aliis. 

Vespere. — Bowels still bound; pulse quick; appetite 
much impaired ; thirst considerable ; has had no sleep ; was 
subjected to the cold affusion this forenoon, from which he 
states he felt himself greatly relieved ; still a look of great 
distress in his countenance. 

Appr. vesicatoria abdom. inferiori et temporibus ; item 
hirudines iv. temporibus. Perstet in aliis. 

Die 6. — Has had two stools in the night; perspires freely 
ever since the affusion; thirst more moderate; slept better; 
appetite still deficient ; on the whole, much improved. 

Habeat vinum rubr. Port diet, cum sago mixtum pro diaeta. 
Capt. spt. aether, vitriol, semidrachmam bis die. Acid, 
muriat gtt. x. quater in die. Appr. cataplasma emolliens 
buboni. P. in aliis. 

Vespere.— Seems to improve; has had no stool since last 
night. Mane habeat solutionem supertartrit, potass, ut supra,. 



260 OBSERVATIONS ON THE 



Repr. cataplasma emolliens. Habeat aq. ammon. acetat. 
drachmas duas tertiis horis. Continued the sponging his body 
with tepid vinegar and water ; barley-water freely given for 
common drink, acidulated with a very small quantity of le- 
mon-juice. 

Die 7. — Much improved ; swelling and inflammation of 
femoral glands disappearing. Applied a discutient lotion to 
the bubo ; was directed a glass of red port wine three times 
a day, and to go on with his other medicines. 

Was removed into another chamber, after being tho- 
roughly washed and shifted. Under the use of these remedies , 
he continued convalescent, and in a few days was gradually 
restored to his original health. 

Andrick. aet. 38, of a weakly constitution Received 

into the pest-house on the evening of the 8th July, about six 
o'clock, when he could give no account of himself. No 
case was sent by the surgeon of his regiment. 

Soon after admission, had an emetic of ipecacuanha and 
antimony; was directed to have sago and beef-tea for diet, 
and acidulated barley-water for common drink. 

Die 9. — Continues in the same state, and senseless as on 
admission ; has a large swelling in the femoral glands of one 
thigh ; bowels rather purged. Port wine added to his 
sago, in very small quantities. Directed to take a table- 
spoonful or two occasionally, of the M. cretacea of the 
L. P. and ten drops of muriatic acid three times a-day. 
The body ordered to be frequently sponged with vinegar 
and spirits of wine, and a repellent lotion to be applied fre- 
quently to the bubo. 

Vespere. — Symptoms aggravated, and the state of coma 



SYMPTOMS, &C. OF THE PLAGUE. 26'1 



more fixed; purges much ; has a very pale cadaverous look; 
The lemon -juice ordered to be left out of his common 
drink, and blisters to be applied to his temples and lower 
belly. 

Die 10 N early in the same state ; is still much purged ; 

about thirty drops of laudanum added to a seven ounce 
and half mixture of M. cretacea, with a little aromatic con- 
fection, and of this, two table spoonfuls were directed three 
or four times a-day. The small quantity of port wine and 
muriatic acid were likewise continued as before, and an 
emollient cataplasm put to the bubo s 

Vespere. — Little change: if any difference, he appears 
rather easier. Perst. 

Diell.— This morning there is a great depression in his 
looks; could not give any account of his sufferings, but 
seems to point at a pain in the region of his stomach and 
belly, which causes his uneasiness. Passed two worms of 
the round kind. Hot fomentations were immediately order- 
ed to be applied, with directions to omit the wine and chalk 
mixture, should the pain continue. In an hour or two after- 
wards, I found him in articulo mortis. 

Peter Webber, aet. 43, a stout man. July 20th.— 
Admitted into the pest-hospital, at six o'clock, P. M . The 
following case was sent me of this man by the surgeon at- 
tached to his regiment. 

" July 20th, 5 rain, before 12 o'clock.— Complains of head- 
ach, and has the femoral glands of both thighs swelled ; tongue 
foul ; some appearance of stupor in his countenance. At the 
examination yesterday evening, and this morning, there was 
nothing observable in this man to lead to a suspicion of his 



<262 



OBSERVATIONS ON THE 



having the Plague. He had no stool for two days previous 
to his attack. When he reported himself unwell, he would 
not admit that there was any pain or uneasiness in the swel- 
lings under his groin, but complained very much of thirst. 
Leeches were directed to be put to his temples, but they 
could not be had in time, before his removal to the pest- 
hospital. Was directed an opening mixture of cream of 
tartar; small doses of the aq. am acetat. and acidulated 
barley-water for common drink. " 

On admission into the pest-hospital, all the symptoms 
were greatly aggravated ; leeches were immediately ordered 
to be put to his temples, and soon after blisters. 

Die 21.- — Much delirium, and wild staring look of the 
eyes, accompanied with voracious appetite, manifested in 
the avidity with which I found him devouring a piece of 
bread given to him by one of the attendants ; much purged ; 
the leeches had drawn but little blood ; a cataplasm was im- 
mediately applied to the buboes, and a trial given to the 
cold affusion. 

The following directions were left with the medical attend- 
ant : 

Habit acid. mur. gtt. x. quater in die. Omittr. mist, su- 
pertart. potassae, et si purgatio continuetr. habeat mist, ere- 
taceam s&pius. Post afFusionem appr. vesicatorium abdom : 
inferior!. Diaeta sit jusculum tenue, sago, et aq. hordei. 

Horn prima, P. M. — -Has continued all the morning in a 
most furious delirium; tore off his blisters; not purged at 
present. Omitt. mist, cretacea. No particular effect pro- 
duced by the affusion. 

Adde aq. hod lb. i. nitri purificat semi-drachm : pro potu. 



SYMPTOMS, &C. OF THE PLAGUE. 263 



Continued in the same state until his death, at twelve o'clock 
at night. 

Yaniwicz, about 30 years old, very healthy and vi- 
gorous. — Admitted into the pest-hospital, on the evening of 
the 21st July, at half past seven o'clock, with buboes and a 
carbuncle situated inside one of the gluteus muscles. 

From the case sent by the surgeon, it appears this man 
had buboes in each groin, and a slight diffused swelling in 
the lower glands of the left thigh, red and inflamed ; had 
symptoms, as the surgeon thought, of gonorrhoea, which he 
discovered four days previously, but concealed ; was in hos- 
pital two years ago, with venereal complaint, since which, 
he affirms, he has not exposed himself in any way to that 
disease. 

At entrance into the pest-house, was ordered beef-tea 
and sago, with acidulated barley-water, for common drink. 
Two grains of calomel were likewise directed night and 
morning, and two drachms of the aq. am. acetat. every third 
hour. The medical attendant resident at the pest-hospital, was 
directed conditionally, i.e. if the symptoms should grow worse; 
to give an emetic of ipecacuanha and antimony, to put 
blisters to the lower belly, smeared with mercurial oint- 
ment, and to apply emollient poultices to the buboes. The 
blisters were directed to be smeared, proceeding on an idea, 
which obtained some credit among the Maltese, that a sali- 
vation would be more readily produced *. 

Die 22. — Says he feels more comfortable, and that the 
pain of the buboes is not so great; tongue cleaner; not so 

* I have to apologize for the mistake at p. 245, respecting my employ- 
ment of mercury. I had not looked over these cases when the passage 
was written. The total failure of the medicine in my hands must account 
for no trace of ray having exhibited it being left on my mind. 



264 



OBSERVATIONS ON THE 



much thirst ; the blister was not applied. Adhibeatur frictio 
leiii3 cum aceto et alcoholi per totum corpus saepius in die. 
Perstet in aliis. 

Vespere. — No visible alteration. Perstet. 

Die 23. — Represents himself as better ; a wild intoxicated 
cast of countenance, yet without any incoherency in speech. 
Blisters were applied to his temples, and to the nape of his 
neck, and a glass of port wine given to him three times a 
day. 

Vespere. — The carbuncle much inflamed. Perset. 

Die 24. — Lost about five ounces of blood by the leeches ; 
was delirious in the night; had four stools yesterday. Appr. 
vesicatorium abdomiui inferiori hydrarg. unguent, fort, illi- 
tum. Omittr. jusculum et vinum. 

Vespere. — Has had three stools in the course of the day ; 
considerably delirious. Barley-water was ordered to be 
given abundantly for common beverage, and a blister to be 
put to the fore-part of his head. 

Die 25. — Very delirious in the night; broke the windows 
of his chamber ; has had four stools since yesterday ; does 
not complain of thirst; tongue cleaner. Perst. 

Vespere. — Much purged. Omittr. aq. am. acetat. et 
hdbeat mist, cretac. unciam : ter die, item camphorae gr. 
v. ter die. 

Die 26. — Has had four stools to-day ; is very incoherent at 
present; was extremely delirious in the night; in other re- 
spects nearly the same ; has torn off all his blisters. Perstet. 

Vespere. —Is nearly in the same state as this morning. 
Perstet. 

Die 27. — Is not quite so much purged this morning ; con- 
tinues in the same state of delirium, and will not allow the 
blisters to remain on. Perstet. 



SYMPTOMS, &C. OF THE PLAGUE. 265 



Vespere.—Seems rather more distinct ; has had but one 
or two stools to-day. Perst. 

Die 28.— Is able to give some account of himself; was 
however delirious in the night. Perstet. 

Die 29. — Seems a good deal improved; carbuncle in a 
state of sphacelus; belly almost natural. Habeat cinchon. 
pulv. drachmas duas ter in die ; acid, muriat gtt. x. ter die. 

Vespere.— Goes on to amend. Perst. 

Die 30. — Nearly in the same state ; the carbuncle was 
scarified, and digestive ointment applied to it. 

Vespere. — Xo alteration in the symptoms. 

Die 31. — Complains of being much purged last night 
which he ascribed to some camphor ; carbuncle sloughing. 
Camphor omitted. 

Die Augusti 1.— Not quite so violently purged. On 
looking accidentally into the hospital-mate's prescription 
book, I observed that one drachm of camphor, and four 
ounces of oil of turpentine had been directed for the car- 
buncle, which, upon inquiry, I found the attendant had 
administered inteimally! This will fully account for the 
purging on the 30th and 31st. 

Vespere. — Purging moderated; in other respects seems 
in a favourable state. Perstet, et habeat sago pro di^ta. 

Die 2. — Purging nearly ceased ; says he slept well last 
night. Perstet in medicamentis ut heri; was conditionally 
ordered a drachm of bark three times a-day, provided the 
purging did not threaten. 

This treatment was persevered in for a few days, and he 
became completely convalescent 

Drummer Gisler. ast. 21, very stout. 

The following case of this man was sent by the surgeon : 

2 M 



266 



OBSERVATIONS ON 



THE 



July 23. — " A tumour apparent in the inferior inguinal 
glands of the right thigh, aceompanied with considerable 
pain; says he felt the pain at last evening's parade ; head- 
ach better since the morning ; tongue rather foul." 

Removed to the pest-house at Floriana, about half past 
seven o'clock, P. M. 

On admission into the pest-hospital, was given eight grains 
of calomel, and fifteen of jalap in my absence ; had plain 
barley -water for common drink. 

Die 24. — Had three stools in the course of the night ; 
countenance much flushed; six leeches were immediately 
ordered to the temples, and about two drachms of the aq. 
am. acetat. every third hour. 

Vespere. — About half past three o'clock rushed out of his 
room in a high delirium ; only about six ounces of blood 
could be taken away by the leeches ; is much purged ; a 
blister was ordered to the nape of the neck ; and, if the de- 
lirium should increase, one also to the forehead. 

Die 25. — Very much purged ; high delirium; great thirst; 
tongue white ; a blister was directed to be applied over the 
crown of the head ; and five grains of camphor, dissolved 
in olive oil, to be given three times a day; an emollient 
cataplasm was put to the bubo ; and he took a small quan- 
tity of the chalk mixture to stop the purging. 

Vespere. — -Has had five stools to-day ; bubo very large ; 
complains of great pain in the head ; the blister was not ap- 
plied to the head yesterday. 

Die 2G. — Died in convulsions, about eight o'clock, A. M. 

Odin. aet. 37, of a weakly habit. 

The following is the case of the patient, as furnished hy 

the assistant-surgeon. 



SYMPTOMS, &C. OF THE PLAGUE. 267 



25th July, 1813, one o'clock, P. M. — " Complains of head- 
ach and thirst, which he says were preceded by shivering ; 
ascribes his illness to the cold air of the guard-room ; slept 
ill on the night preceding ; skin hot ; eyes rather suffused ; 
tongue foul ; has had no stool to-day ; has taken an ounce 
of Epsom salts, which he vomited almost immediately, and 
without producing any effect in opening his bowels ; states 
he had intermittent fever in Sicily a year ago ; abour four 
o'clock there was an appearance of redness in the left groin, 
but without any visible swelling ; had an emetic about half 
past four o'clock. 

" Die 26, hora 6ta, A. M. — Is considerably better ; does 
not complain of any pain in the groin, but there is an evi- 
dent swelling where the redness had appeared, attended 
with inflammation ; tongue rather foul ; seems feeble ; 
removed to the pest-house at Floriana 12 o'clock this fore- 
noon." 

Hora 12 M.— This patient walked to the hospital, re- 
fusing to be carried on a hand-bier, of which he expressed 
a great horror. Since his admission into the hospital, ap- 
pears very ill ; has had an opening mixture of cream of 
tartar, his bowels not being free for some days. Two 
grains of calomel, and two of antimonial powder, were di- 
rected to be given every four hours. Ordered two drachms 
of the aq. am. acetat. every third hour. 

Vespere. — Continues in the same state. Perst. 

Die 27. — Has had two stools to day ; complains of great 
thirst; has been in a state of low delirium since yesterday, 
after admission into the pest-hospital ; is very much de- 
bilitated. Perstet in medicanientis ; habeat jusculum temie 
pro diacta. 



268 



OBSERVATIONS ON THE 



Vespere. — Is nearly in the same state as this morning. 
Habeat camph. gr. v. ter die. The attendant says he passed 
something like corrupted matter, mixed with blood, in his 
stools. 

Die 28. — Died this morning at half past six o'clock. The 
whole body was of a bluish cast after death ; the bubo never 
tended to suppurate. The same state of low delirium that 
succeeded his admission into the pest-hospital, continued 
until death. He never mentioned any particular complaint, 
or expressed any pain. 

KONOBLESKY, jet. 26, Stout. 

The following case was furnished by the surgeon : 
23d July.— " Has an evident florid tumour, first disco- 
vered yesterday evening, in the inferior inguinal glands of 
the left thigh, and a carbuncle, situated in the middle of the 
tibia. He complained also of head ach this morning, which 
has been relieved by bleeding from the nose ; tongue rather 
foul ; symptoms continued much the same when he was re- 
moved to the pest-hospital at Floriana, about half-past 12 
o'clock, M." 

Die 23. — On admission into the hospital, the following 
directions were given : 

To apply a repellent lotion to the bubo ; to give two drachms 
of the aq. am. aeetat every three hours ; and two grains of ca- 
lomel night and morning ; to drink copiously of barley-Water ; 
and to confine himself entirely to weak beef-tea for ordinary 
diet. 

Die 24. — Had two stools this morning ; tongue not very 
foul ; is not much altered from the state he was in yesterday 
An emollient poultice was directed to the carbuncle ; and 
the other medicines to be continued. 



SYMPTOMS, &C. OF THE PLAGUE. 26,Q 



Vespere. — Two passages by the belly since last night ; 
same appearances of countenance. Abrad. capillitium et 
appr. vesicatorium occipiti ; omitt. jusculum ; perst. in aliis ; 
capt. camphorce, gr. v. ter die. 

Die 26. — In the same state nearly. Last night he ran out 
of the hospital in a high delirium. Had four stools to-day. 

Vespere. — Perstet. 

Die 27. — Has torn off all his blisters, and continues still 
very delirious. Perst. ut antea. 
Vespere. — Not so well. P. 

Die 28. —Seems rather more composed and distinct this 
morning, and was able to communicate that he slept some 
in the night, and had two stools. Habeat acidi muriat # 
gtt. x. quater in die. Has a look of much anxiety and de- 
pression. Habeat vin rubr. cyathum ter in die. 

Die. 29. — No change. Perst. 

Die 30. — Carbuncle has begun to slough ; some digestive 
ointment was ordered to be applied to it. Appearance of 
countenance more settled. 

Die 31. — Most severely purged in the night. On looking 
into the prescription-book of the hospital mate, I observed 
the same application for the carbuncle as ordered for Yani- 
wicz above ; viz. four ounces of oil of turpentine and one 
drachm of camphor. 

Vespere. — Continues still much purged, and complains of 
great griping and uneasiness about the belly. 

Die Augusti 1. — I found the same mistake had been com- 
mitted as in the case of Yaniwicz, and that the oil of tur- 
pentine and camphor had been given internally. 

Die 2-— The purging moderated, and he feels much 
easier. Cont. medicamenta ut heri. Habeat cinchona 



270 



OBSERVATIONS ON THE 



drachmam imam ter die ; omittendo tamen cinchonam et 
vinum, si purgatio minitet vel dolor abdominis. 

Vespere.— Ulcer more healthy ; bubo opened this morn, 
ing, and discharges freely. These medicines were perse - 
vered in, and, in the course of a few days, he was restored 
to a perfect state of convalescence. 

Nicola Seiler. aet. 2fi, of a vigorous constitution. 
The following case was furnished of this man's disease : — 

11 o'clock A. M. 28th July, 1813.— " Complains of head- 
ach, thirst, want of appetite, an inclination to vomit, and 
pain in the limbs ; sa\she felt headach yesterday evening, 
and vomited this morning. Tongue a little foul ; skin hot ; 
had an emetic of ipecacuanha and antimony, and a large 
quantity of rice water for beverage. 

" 29th, morning. — Headach and thirst increased ; no 
stool yesterday ; complains of a pain in the right axilla ; but 
there is no perceptible swelling ; had leeches to his temples ; 
and took an ounce of Epsom salt ; succeeded in obtaining 
two dejections, and about 10 or 12 ounces of blood. 

" At half-past 12 o'clock. — Says he feels no pain of head 
or any other part of the body, the axilla excepted, in which 
there is a very slight swelling. Put a stop to the haemor- 
rhage, which it was found difficult to do from the large- 
ness of the leech bites. Repeated the aq. am. acetat 

" 30th July, about 5 o'clock, A. M. — Said he slept 
well ; no head-ach ; scarcely any pain in the axilla, nor in 
any other part of the body. Swelling in the axilla not in- 
creased, and he feels much better in every other respect, 
tongue white. 



SYMPTOMS, &C. OF THE PLAGUE. 2?1 

11 8 o'clock.— Continues the same." 

Thus far proceeded the surgeon's report. 

At my visit some short time after this last report, I found 
the patient in a state of low delirium, and the swelling in the 
arm-pit increased. Immediately blisters were directed to hi* 
temples, which he tore off almost as soon as they were ap- 
plied. The other medicines were continued. He died in 
the course of the evening. 

After death he was covered with dark-coloured spots of 
about the size of a farthing each. 

Shortly before his decease, about 10 gr. of camphor were 
administered. 

Bregati, aet. 36, of a weakly habit. The surgeon sup- 
plied me with the following case of his patient : 

August 2d, 1813, half-past 6 o'clock, A. M.— " Com- 
plains of headach, nausea, and some thirst; skin hot; tongue 
rather foul. Has a carbuncle on the outside of the left leg, 
and some pain in the left groin, but there is no evident 
swelling. Has been subject to attacks of fever formerly. 
It. Pulv. ipecac, gr. xv. 

" 10 o'clock. — Emetic operated, but does not seem to 
have produced any other effect; much dejection, and ap- 
parently confusion. At one o'clock, P. M. applied 
leeches to his temples, and took the aq. am. acetat. Head- 
ach still continuing, about 4 o'clock applied a blister to the 
temples. Removed to the pest-hospital at Floriana at a 
quarter before six o 'clock P. M." 

Thus far the case as given by the surgeon. 

At my visit to this man about 4 o'clock P. M., in com- 
pany with the deputy-inspector of hospitals, it was agreed 



272 



OBSERVATIONS ON THE 



by us, that there was some appearance of swelling on the 
left thigh, where he complained of having pain. The leeches 
took away not more than about five ounces of blood. 

After the patient's admission into the pest-house, his com" 
plaints were of headach, thirst, and debility ; he had had no 
stool since the morning; much appearance of distress and 
wildness in his looks ; tongue foul. 

The following directions were given, viz. that he should 
have plenty of plain barley-water for common drink; that he 
should have two grains of calomel and two of the pulvis an - 
timonialis every fourth hour; and that his body should be 
frequently sponged with vinegar and spirit of wine. 

Die 3. — Wildnes3 of countenance the same, complains of 
great headach ; face flushed ; slept very ill last night ; no 
appetite; great thirst; no stool since yesterday. A blister 
was directed to be applied without delay to his temples and 
nape of the neck ; and an ounce of Epsom salt So be given, 
with copious dilution, continuing the other medicines. 

Vespere. — Had one trifling evacuation by his bowels 
about half-past three o'clock P. P.I. Complains of some 
pain in the belly ; tongue not very foul ; seems restless and 
very confused. A blister was ordered to the lower belly ; 
and a clyster to be thrown up. Instead of the calomel and 
antimonial powder, two drachms of the aq. am. acetat. were 
substituted; nitre was added to his common drink in small 
quantity. Conditional orders left with the ho&pital-mate, 
if any pain of bowels should supervene, to apply hot fomenta- 
tions without delay, and, failing of being able to procure any 
sufficient relief by the bowels, to give two drachms of the 
Epsom salt every third hour with plentiful dilution ; or ii 
these means should prove insufficient, to give an ounce of 



SYMPTOMS, &C. 



OF THE PLAGUE, 



273 



castor oil, aud throw up a purgative injection every two 
hours. 

Die 4. — He had 4 stools since 9 o'clock last night, and 
without the clysters ; still complains of pain in the head ; 
much confusion and incoherency ; face flushed ; tongue not 
very foul; pain of belly removed; blisters rose well on 
the abdomen, but not on the temples; they were accord- 
ingly ordered again to be put to ; an emollient poultice was 
directed likewise to the bubo, and the aq. am. acetat to be 
discontinued, if the purging should go to excess. 

Was ordered five grains of camphor three times a day, 
Vespere. — Passed three stools since morning, great part 
of which consisted of scybala; vcmited the camphor and aq. 
am. acetat.; respiration hurried ; tongue not very foul ; great 
headach; some pain of belly ; the camphor was omitted, and 
some gum Arabic added to his common beverage. The aq. 
am. acetat. was thrown up, in consequence of which the sa- 
line mixture was given in its place. 

Die 5. — Had a great many stools since the visit last 
night; some of them rather copious; appears relieved to day; 
pulse and respiration still more hurried; great anxiety in his 
looks ; complains now of no pain in his bowels ; thirst great; 
slept a little in the night ; the bubo causes much pain though 
not large. Was ordered five grains of camphor three times 
a day, and the muriatic acid as before. An emollient poul= 
tice was put to the bubo. 

Vespere. — This evening is very restless and delirious ; 
tears off his blisters ; oppressed with constant nausea and 
retching; a blister was put to his forehead, repeating the 
saline mixture and camphor as before. 

Die 6 —Very delirious in the night ; tongue not very foul; 
2 N 



274 



OBSERVATIONS 



ON THE 



will not drink his barley-water; expresses great distress 
from the pain of the bubo ; affected with a degree of tenes. 
mus. The muriatic acid was omitted. 

Vespere. — Has had a great many trifling evacuations by 
stool. About 8 o'clock P. M. he died. 

After death his lower extremities were all equally of a 
motley bluish cast, with some small petechial over his breast 
and arms. The bubo was completely stationary for some 
days previous to death. The tongue, though whitish, was 
remarkably clean throughout the whole of his illness. 

N. B. This patient complained of a great pain in his throat, 
which prevented his being able to drink, although he called 
for it with great avidity. 

In conclusion, let it be observed that, for 
the reasons assigned (passim) in a former 
chapter, I have purposely abstained from 
entering into any speculative disquisitions 
on the theory of this disease, or its place in 
the nosology, convinced, that until we shall 
have acquired a more distinct and extended 
knowledge of the phenomena, with their de- 
pendencies, and of the effect of remedies, any 
such attempt would be productive of no ad- 
vantage. Indeed, I very much doubt whether, 
in most cases, the advantages arising, in poitnt 



SYMPTOMS, &C. 



OF THE PLAGUE. 



275 



of practice, from nosological distinctions, are 
not more than counterbalanced by the tend- 
ency which such distinctions have to repress the 
investigation of facts, and to perpetuate errors 
under the imposing sanction of their inventors. 

That the Plague arises from the absorption 
of a specific poison, I cannot see how a rea- 
sonable doubt can exist in the minds of any 
who have paid even a superficial attention to 
the symptoms. Of the whole number who 
passed through the disease in Malta, I be- 
lieve it is understating the fact, to say, that 
at least two-thirds were affected, more or less, 
with inflammation or tumefaction of the 
glands, or lymphatics. Nor do I conceive it 
sufficient to set aside this view of its mode of 
production, that sometimes no traces of such 
inflammation or tumefaction were to be de- 
tected before death ; for in a disease which 
runs its course with such singular rapidity, 
it may happen from the sudden and strongly 
sedative impression which this contagion may 
be peculiarly fitted to exert on the brain 
and nerves, that the powers of life become 



276 OBSERVATION* ON THE 

too exhausted for the usual lymphatic or 
glandular excitement to be produced before 
the fatal event takes place ; in proof of which 
we know that in some other diseases con- 
fessedly arising from contagion, the brain 
and nerves, or stomach, are violently dis- 
turbed, or even death itself ensues before the 
least appearance of the specific eruption is 
discernible. That the eruption of buboes 
should proceed, as some have contended, from 
an effort of Nature to expel pestilential matter, 
seems very improbable for this plain rea- 
son, that in the Plague, not less than the ve- 
nereal disease, their retrocession is often per- 
fectly harmless. When, therefore, death fol- 
lows the retreat of these swellings, we may 
fairly conclude that it is not owing to the 
retention of matter which required to be ex- 
pelled, but that is the consequence of such a 
depressed state of the vis vitce^ as in the 
worst cases prevents their coming out 
altogether. Did the production of these 
tumors bear any proportion to the violence 
of the disorder, there might be some colour of 



SYMPTOMS, &C. OF THE PLAGUE. 277 



probability for regarding them as critical se- 
parations of morbid matter. On the con- 
trary, they often appear at the very com- 
mencement (as occasionally has happened 
in respect to the eruption of measles and 
small pox) without being preceded by the 
least degree of fever, or any other symptom 
of morbid derangement. 



THE RND. 



The reader is requested to observe, in reference to the errata 
and obscure passages in the following evidence that I have not felt 
at liberty to make any alteration from the impression printed 
by order of the House. In the present copy there occur, I believe, 
but two mistakes which are departures from the original, viz. at 
p. 19, I. 5, where considerably is put for inconsiderably, and at 
p. 39. I. 17, aptitudes for aptitude. One of the most obscure sen- 
tences will be found at p. 20, I. 4, in which it was intended simply 
to observe, that so far from there being any thing remarkable in 
the state of the public health, or in the climate previous to the 
Plague, the very reverse was the subject of general remark. Other 
minor inaccuracies are plainly oversights of the copyist. 

For such defects of expression, Sfc. as are strictly chargeable to 
myself I can only urge the considerations slated above at p. 12 of my 
Letter to the College, and that when evidence is notm^by the 
short-hand writer, not the most trivial inadvertency can escape 
being recorded — " Semcl emissum volat irrevocable." 



APPENDIX, 

Containing Minutes of the Author's Evidence, 

BEFORE THE 

£t\ect Committee 

OF THE HOUSE OF COMMONS; 

Appointed to consider the validity of the doctrine of Con- 
tagion in the Plague. 

TOGETHER WITH THEIR 

REPORT. 

ORDERED, BY THE HOUSE OF COMMONS, TO BE PRINTED, 14 JDNE, 1819. 



B* 



2 



THE AUTHOR'S EVIDENCE 



Jovis, 25° die Martii, 1819. 
SIR JOHN JACKSON, BARONET, 
In the Chair. 



Sir Arthur Brooke Faulkner, called in ; and Examined. 

STATE the opportunities you had of considering the 
Plague ? and the nature of contagious distempers in general, 
in the course of your practice ? — The only opportunity I 
have had of seeing the Plague was in the Island of Malta. 

On what occasion ? — In the year 1813. 

When the Plague prevailed?— When the Plague pre- 
vailed in the island. 

What situation at the time did you hold? — I was physician 
to the forces. I was the only staff physician employed 
during the greater part of that service. 

W as you there at the time it broke out first? — I was. 

And attended as a medical man during the whole course 
of it?— Not during the whole course. I did not attend 



BEFORE THE SELECT COMMITTEE. 



3 



officially until the army became infected. I was not per- 
mitted when the natives only were infected. 

But you was present? — I was present during the whole 
period of the Plague *. 

And practised as one of the principal men of the army ?— 
After the army became infected, 1 practised as physician to 
the forces. 

What is your opinion respecting the mode in which the 
Plague, in general, is generated and communicated ?— I 
believe it is generated or produced by a contagion, sui generis 
quite peculiar and specific, and that it is communicated only 
by contact or close association with the person or thing in- 
fected. 

What are your reasons for believing that it is communi- 
cated only by contact or association, and not by a certain 
state of the air ? — My reasons are drawn from the course the 
Plague took from its first entrance into the Island of Malta, 
until its cessation. It was communicated in the first in- 
stance in the direct line of contact. It could be traced to 
have been propagated in the direct line of contact, in the 
city of Valetta, and from the city into most of the casals or 
villages, where any history could be obtained of its intro- 
duction. 

Will you have the goodness to state the instances of its 

* *. c. in Malta. Gozo continued to suffer ;ifter I left the Mediterranean. 



4 



THE AUTHOR'S EVIDENCE 



communication by contact, during your own experience at 
Malta, from your own knowledge?— The first case of the 
communication of the Plague was, in my opinion, from a 
vessel, the San Nicolo, in the harbour, to the family of a 
person of the name of Salvatore Borg. 

The vessel lay in what harbour ? —It was lying in the har- 
bour contiguous to the city of Valetta ; the harbour is called 
Marsamuchet. 

State the. circumstances? — To prove that it was from 
this vessel the infection was received, I shall crave per- 
mission to read a letter addressed by myself to the governor. 
I am not quite sure of the verbal accuracy of the letter. 
After the vessel arrived in the harbour in March, the town 
became extremely alarmed, and, among the rest, myself. 
I understood, but this 1 cannot pretend to vouch for, that 
several merchants had remonstrated against the vessel re- 
maining in the harbour. Participating in the common alarm, 
I thought it my duty, though not called upon in my 
official situation, to represent the consequences that appeared 
inevitable in permitting the ship to lie there ; and, therefore, 
though not solicited, 1 communicated the following letter to 
the governor :* 

Go on with your detail?— My apprehension of the disease 
finding its way into Valetta, from the lazaretto and Plague 

* See this letter, p, 4-3. 



BEFORE THE SELECT COMMITTEE. 



.5 



ship, arose from my knowledge that the persons appointed 
as guardians, were taken from the lowest part of the com- 
munity, and paid, as it appeared to me, very inadequately, 
somewhere from one shilling and sixpence to two shillings a 
day; and having recollected from reading the history of a 
Plague that visited the same Island in 1675, that it crept 
on shore from an infected vessel unobserved, I thought I 
was justified in entertaining the same fears on the present 
occasion. Accordingly on the 16th of this month, six days 
after this letter was presented to his Excellency Lieut.-Gen. 
Oakes, the first infected case occurred in the town of Va- 
letta; it was the case of the daughter of Salvatore Borg. 
She died with well marked symptoms of the disease, 1 
think on the 19th April. Two other persons of the same 
family died on the 2d May, all with well marked symptoms 
of the disease. 

Will you trace the communication between them and the 
vessel? — From the family of Borg it made its way in a di- 
rect line into the family of one Maria Agius, a school-mis- 
tress, who, together with others she immediately communi- 
cated with, were attacked by the Plague, and all of whom 
(with some of her scholars, I heard) were seized or perished 
with well-marked symptoms of the disease. I ought to 
revert to that part of your inquiry, which is of most conse- 
quence, namely, the communication between the vessel and 



6 



THE AUTHOR'S EVIDENCE 



the town of Valetta. I hold it as hardly requiring proof, 
that the disease should have found its way from an infected 
ship in the harbour, when I consider the apparent connexion 
between the cause and effect, arising out of the arrival of 
the vessel, and the almost immediate verification of my pre- 
diction to the governor; and recollect besides, that the 
island had not been infected for 130 years before. I con- 
sider these circumstances as conclusive. But, in the next 
place, some new linen was discovered in the house of 
Salvatore Borg, which was confidently rumoured to have 
been brought from the infected vessel; and it was further 
stated, but of this I have no certain authority, that when the 
vessel returned to Alexandria, the infected place from 
whence it came, there were some bales missing. 

Have you any reason to believe that the family infected, 
among whom the disease broke out, had direct communica- 
tion with the ship ; and what means have you of knowing it ? 
— When I consider what appeared to me the imperfect state 
of the quarantine system at Malta, I can only say, I think it 
an event not improbable, that some of the family might have 
got goods from this vessel *. 

Can you state that any communication took place, and 
what, between the family of Borg and the family of Maria 

* See Dr. Granville's statement above, p. CO. 



BEFORE THE SELECT 



COMMITTEE. 



7 



Agius, where the disorder next appeared ? — The families 
of Maria Agius and Borg were intimately acquainted with 
each other, and she was constantly employed in relieving 
the afflictions of the latter, when taken ill of the Plague. 

From the family of Agius could you trace the progress of 
contagion to any other family ? — For my own part I dropped 
the inquiry there ;* the foci of contagion became so rapidly 
multiplied, that it appeared to me impossible to carry the in- 
vestigation in a direct line further in that populous city ; but I 
am in possession of documents furnished to me by one of the 
captains of the lazaretto himself, a man of strict integrity, 
and many years employed in that official situation, showing, 
that the contagion made its way in a direct line from Valetta 
into most of the infected casals or villages ; these documents 
I can produce if required. In the next place, in pursuing 
the course of the disease by contagion, I should beg leave 
to remark, as a very important circumstance, that the means 
of its communication to the small contiguous island of Gozo, 
at a late period of the calamity, can be distinctly made out. 
A man belonging to an infected family in one of the casals, 
made his escape with a box of clothes into a neighbouring 
cottage ; it was speedily found out that he had escaped, and 
he was accordingly apprehended and sent to the lazaretto. — 

* By the Government Journals of Malta I have been enabled to trace 
the cnnagion still farther, as stated above, at p. Gl et seq, 



8 



THB AUTHOR'S EVIDENCE 



On his enlargement from the lazaretto, he returned to his 
cottage, where he took this box of clothes that had never 
been suspected to be there, but had been concealed; and he 
hired a boat, and carried this box of clothes to the island of 
Gozo. The first family infected on the island was the family 
at whose house he arrived, and to which place he carried 
the box of clothes. It was a marriage present, I under- 
stood ; and a priest acquainted in the family was one of the 
first victims ; he died with well-marked symptoms of the 
Plague. I have not had it in my power to trace the direct 
communication further. 

Did the individual who conveyed the clothes take the 
Plague; was he himself infected? -I am not prepared to 
answer that question, but I rather think he was; many per- 
sons were not infected by the disease, that were taken from 
the very bosom of those families, who all died of it. 

Do you happen to know whether this person had commu- 
nication personally with the individual who took the com- 
plaint, as well as by giving the goods?— He lived in the 
family; there was a marriage about to take place, or had 
taken place, in it. 

How long after he got this box of clothes was it before 
the disease broke out? — Within a short time. 

What length of time were the clothes locked up in the 
box, between the time of their being infected, and the box 



BEFORE THE SELECT COMMITTEE. 



9 



being opened, and the clothes given to the people in Gozo ? 
— During the term of his quarantine, I believe somewhere 
about twenty days ; I am not quite prepared to answer when 
it was opened. All I can say is, that the box was carried 
by this man to a cottage,* and was concealed from those 
who went to take him to the lazaretto. 

Do you know whether any person in the cottage, where 
the box was deposited, took the Plague? — I cannot answer 
that question. 

Do you know whether there was any communication, any 
thing that could have conveyed the disorder from the ship 
San Nicolo to the family, except the linen? — I am not aware 
of any thing ; I rest my whole evidence on what I before 
specifically stated, namely, the tendency of the disease to 
propagate in a direct line, and the circumstance of my pre- 
diction being followed in four or five days by its consumma- 
tion, and the collateral consideration of the island not having 
been infected with the Plague for an hundred and thirty 
years. 

And you conceive that to have been a sufficient cause to 
account for the propagation of the Plague ? — I should think 
so. 1 beg to be understood in giving this evidence, that I 
was not present myself, and therefore I cannot speak with 

* i. e. near to the infected casal. 

C* 



10 



TH E AUTHOR'S EVIDENCE 



confidence as to the linen being found in Borg's house ; I did 
not see the linen myself. As to the other circumstance of 
the disease propagating in a direct line to the casals, I had 
the documents from one of the captains of the lazaretto. 

You have stated, that in the family of Borg, and in that 
of Maria Agius, the schoolmistress, and also in the family 
in the island of Gozo, the different individuals died with 
well-marked symptoms of the Plague ; do you state the 
well-marked symptoms of the Plague to have appeared, 
from your own individual knowledge, or from information 
derived from others ? — From information derived from others. 
With respect to the first case, I had official information 
communicated by the head of my department, I received an 
official letter from him on the subject. With respect to 
Maria Agius, it was a fact so notoriously known, that I 
apprehend any evidence on this point would be unnecessary. 
With respect to the infection of the casals in a direct line, 
my evidence, as I have stated above, rests on the written 
statement of one of the captains of the lazaretto, employed 
in the service during the Plague of Malta. 

Is he a medical man ?— No ; it is not necessary he 
should be so to fiii that office. 

With regard to Gozo?— With respect to Gozo, I have the 
information of some respectable authority *, but I do not 

* From the Captain of the Port, and others, together with current public 
testimony. # ■ 



BEFORE THE SELECT COMMITTEE. 



recollect his name; it is, however, a well-known fact. 

Then, in point of fact, not one of these cases, in which 
you state the symptoms to have existed, was from your own 
personal observation ?— Not one. I was not officially em- 
ployed; I offered my services in the native hospitals; but 
they were not received, on this ground, that they might be 
wanted for the army. 

Had you any intermittent or other fever at Malta, during 
the Plague?— 1 had none under my own immediate eye or 
care ; but I understood there were a few, and those very 
mild, principally occurring, or, indeed, altogether occurring, 
towards the autumn *, or the latter end of the year 1813 ; 
but as I have not seen any of the cases, I can only speak 
from hearsay. 

Did those instances occur before the Plague broke out? — 
They had, I understood, been occasionally numerous in 
preceding years. 

The instances you state to have prevailed before the 
Plague broke out, were they the marsh fevers?--! am 
not aware that any had occurred the year before ; i. e. I can- 
not specify, myself, on my authority, that any occurred the 
year before ; but I understood that they were of frequent 
occurrence in every year. 

* This will be found more accurately stated above, when treating of the 
supposed pesty'erous power of marsh miasma, 



12 



THE AUTHOR'S EVIDENCE 



Was the Plague particularly prevalent in the places where 
the marsh fevers prevailed ?— Not at all particularly prevalent 
where the marsh fevers were most generally produced. 

Is there any similarity between the marsh fever in Malta 
and the Plague ; — T never could trace any series of symptoms 
that could lead me, iu the slightest degree, to suspect any 
identity between them ; but I have known the Plague to 
personate in certain symptoms in almost every possible form 
of fever, and I have known it to be entirely free from every 
kind of fever ; there is no certain type to which it can be affixed . 

Do you mean to say, that there is no distinct symptom 
that marks the Plague as distinct from every other fever ? — 
I do mean to say, that fever is not an essential attribute of 
the Plague ; it is frequently mortal where there is no fever. 
It is an extraordinarily anomalous disease, which defies, (I 
should rather say, has almost defied) definition. Dr. Cullen, 
I conceive, has defined it best; but even his definition is 
not a correct one. In fact, I may say, it has hitherto 
baffled nosologists scientifically to define it. 

Are there not symptoms that distinguish the Plague, in a 
manner which cannot be mistaken ?— There are symptoms 
which are sometimes called characteristic symptoms, but 
they are not constantly present. The most frequent and 
constant symptom was a peculiar cast of the eye, and a cer- 
tain appearance of the tongue; the eye had the appearance 



BEFORE THE SELECT COMMITTEE. 



13 



described by Russel, of a muddy dull colour ; I believe that 
to be the most frequent and most characteristic symptom of 
the Plague. As to buboes, carbuncles, and appearances of 
the skin, they are not constant. In many of the most fatal 
cases, the patient perished before the buboes or any other 
eruption made their appearance ; many without any other 
appearance than that of the eye. 

What was the state of the pulse ? — The pulse had been 
felt occasionally, through a tobacco-leaf, and was, in many 
instances, extremely rapid. The fine for feeling a pulse was 
several days quarantine; if any medical man had felt a pulse, 
he was subject to this quarantine. 

Can you show that prompt separation has been effectual 
in securing persons from contagion ?— I can, in many in- 
stances ; the instances would be difficult to detail, they are 
so numerous. 

Did the disease extend to Sicily, or the neighbouring 
islands ?— It did not extend to Sicily, in consequence of the 
prompt precautions that were adopted : and had there been 
the same at Malta, my persuasion is, that the disease would 
have been resisted, in limine. 

"Were quarantine restrictions found effectual in resisting 
the Plague at Malta? — Wherever proper quarantine restric- 
tions were imposed with firmness, steadiness, and prompt- 
ness, they seemed to be altogether effectual in preventing 



14 



THE AUTHOR'S EVIDENCE 



the extension of contagion; but the quarantine system * seemed 
to me so extremely lax from the beginning, for several months, 
that it would have been next to impossible the disease should 
not have been widely disseminated through the island. I may 
enumerate, as instances of this laxity in our quarantine system 
at Malta, that there was no complete census taken of the 
population, with a view of detecting cases of infection, until, 
I think, the 19th May, 1813. There was not a complete 
and sufficient corps of trusty guards until the month of Au- 
gust; the people were not shut up in their houses until, I 
think, the month of August ; that is, not universally shut up, 
probably partially. It is notorious, that contact constantly 
took place in the street, previous to the organization of this 
corps of guards, and the shutting up the inhabitants in their 
houses ; I have official documents to prove all these points 
I have been just stating. 

Was the Plague ever known to be received in the laza- 
rettos?— It has been known; 1 have heard many instances 
related to me by the Maltese, and here is evidence of one ; 
I have brought the title-page of a book, which represents a 
monument raised to the memory of a grand master, for having 
arrested the disease. 

In what year? — 1743.f 

* This word is taken in a wide sense, and includes the system of Police. 
+ On looking more narrowly into this document, I find it refers only to 
the measures which protected Malta when the Plague was raging in Sicily. 



BEFORE THE SELECT COMMITTEE. 



Do you know any thing of the introduction of the former 
Plague, that ravaged Malta, and when did it occur ? — I beg 
to refer to a paper I published on the disease, during my 
engagement on the Plague at Malta, which was communi- 
cated to the Edinburgh Medical and Surgical Journal, and 
published 1st April, 1814. The passage I wish to read to 
the Committee, is this : " It is somewhat remarkable, that 
the history of the introduction of the Plague, when it made 
such great ravages on the last occasion on the island, about 
a century ago, was nearly similar to what is circulated of 
the present; being attributed to some linen brought from a 
Levant vessel, by a Maltese shopkeeper; which, after pro- 
ducing the disease in all those who first came in contact 
with it, ultimately disseminated the malady throughout the 
whole population." 

During the late Plague at Malta in 1813, was the disease 
arrested when the quarantine system was rigidly acted upon ? 
— It was : from the moment that an adequate and a regularly 
organized police was established, and the inhabitants shut 
up in their houses, and other strict measures of quarantin e 
enforced, (which was the case at a very late period) in the 
month of August, the Plague did rapidly decline. 

How was the disease stopped at last? — By what I have 
just stated : by the organization of a sufficient corps of trusty 
guards and police restrictions, and by shutting the inhabi- 



16 THB AUTHOR'S EVIDENCE 

tants up in their houses. I could name a number of other 
circumstances connected with the means of preventing it. 

How were the medical attendants preserved? — With 
respect to the military hospital, of which I can speak from 
experience, the hospital in which I attended, (the pest hos- 
pital,) they were, in my opinion, preserved by wearing a 
dress of oiled silk,* which prevented the possibility of any 
contact of infected matter with the skin, and probably also 
by its promoting free and copious perspiration, and in conse- 
quence preventing absorption. 

When was the Plague stopped ; at what time ? — I am 
not quite sure whether it was in December. 

Can you state when it began to decline ? — It began before 
the month of August. 

What do you conceive the hottest period of the year at 
Malta?— I am not prepared to answer that question; I be- 
lieve the month of August. I have kept a thermometrical 
table ; but having it only for one year, the results of my ob- 
servations are probably insufficient. 

What was the temperature of the atmosphere at the period 
when you conceive the decline to have been apparent ? — 
The 16th July appears to be the day when the Plague was 
at its height , sixty-seven died that day ; the thermometer 

* A modification of this opinion has been given in a preceding part of 
this Volume. 



BEFORE THE SELECT COMMITTEE* 



17 



was at eighty-one, at four o'clock in the afternoon. In the 
morning at six o'clock at seventy seven, and at ten at eighty- 
one and an half. The next day thirty-six died ; the ther- 
mometer was at eighty-two, and in one part of the day at 
eighty-three. On the 18th of the month, fifty died; the 
thermometer was in the course of the day at eighty-one. 
On the 29th forty-one died, the thermometer was at seventy- 
nine. On the 20th of the month forty-three died. 

State the period at which thare was a sensible decrease ? 
— I think from the 16th of July there was an average 
decrease, though a very irregular kind of decrease ; but the 
thermometer was rather higher than lower. 

How far was the establishment of the police precautions 
to which you have alluded, coincident with the decrease of 
the Plague, with the visible decrease of the Plague 1— This 
question requires a cautious answer. The gentleman ap- 
pointed at the head of the police, begun to organize his sys- 
tem on the 3d July ; the disease extended its ravages after 
he had organized his system in some degree; but was not 
perfectly organized till the 2d August, i. e. it did not shut 
the people up in their houses, nor was there an absolute pro- 
hibition of contact; but as soon as it did enjoin absolute 
prohibition of contact, and shutting the people up in their 
houses, the disease declined.* 

* See Government Gazette of Malta. 
D * 



THE 



author's EVIDENCE 



Then it appears the decrease was not very visible till these 
precautions were put strictly in force? — Not so visible. 

State from the period at which they were strictly enforced, 
namely, the 2d August, what was the average decrease 
from that time?— On the 2d August fifty persons died, 
on the 3d August forty-eight, on the 4th twenty-seven, on 
the 5th forty-seven, on the 6th forty-three, on the 7th thirty- 
five, on the 8th thirty-seven, on the Oth twenty-four, on the 
10th twenty-six, on the 11th twenty-eight, on the 12th 
twenty-six, on the 13th thirty-one, on the 14th — 

Instead of putting the result of every day, look at your 
table and see when the decrease became considerable?— I 
have brought it down since the 16th July until 14th August, 
to less than one-half ; I have brought it down to thirty-one 
instead of sixty-seven, in less than a month, 

From the 16th August did it go on gradually decreasing, 
till it disappeared ? — It went on decreasing on the average, 
but not regularly. 

At what period did it finally disappear ? — On the 19th 
October ; in my note of this day is stated the last * occur- 
rence of a case of Plague in Valetta. 

Did it continue in other parts?— In some of the casals 
for a considerable time. 

* It appears that one of the Third Garrison Battalion was infected oa 
the 23d of October, and was properly the last acknowledged case of Plague 
in Valetta. 



BEFORE THE SELECT COMMITTEE. 



19 



Have you any doubt whatever, that the decline of the 
complaint was produced by the prohibition of the intercourse 
among the inhabitants ?— I feel satisfied that it was very 
much owing to the prompt measures of police ; and my 
reason is, that the thermometer rose considerably in point of 
fact, while the disease was decreasing fast. 

Is there any other cause to which you can attribute the 
decrease and cessation of the Plague ?— I really do not see 
any other cause. 

In your observation of the Plague, has it appeared to you 
that it subsists only in a given temperature, neither in very 
great heat or very great cold? — During my residence at 
Malta it did not appear to me that the temperature of the air 
had any thing to do with it. In my own opinion, I do be- 
lieve that a very high or a very low temperature would 
check it. 

Will you state the opinion you entertain, from the best 
sources derived, what degree of heat is not consistent with 
the Plague ? — I can only speak from my reading, on that 
point. I believe that materially below 60 or probably at 60 
degrees of heat it cannot subsist ; but it is bare conjecture. 

You had never an opportunity of observing the Plague ex- 
cept at Malta ?— No. 

Was there any thing remarkable in the state of the ther- 
mometer at the time the Plague broke out at Malta ?— No- 
thing, I believe. 



20 



THE AUTHOR'S EVIDENCE 



What was the temperature at that time ? — The thermome- 
ter, on the day the first case was reported to have taken 
place, was at 64 ; that was on the 16th April. 

What was the state of health on the island, before the 
Plague broke out ? — To the best of my knowledge nothing 
remarkable. If there, was any thing remarkable with regard 
to its climate, it was that there was nothing very remark- 
able, for the people were wondering that there was nothing 
remarkable in the state of the air to produce Plague ; there 
was nothing anterior to the breaking out of the Plague, at all 
leading to any reason why it should exist unless by con- 
tagion. 

At what time did the first case of Plague appear among 
the soldier? ?— Without referring to my official letter I can- 
not exactly state. 

What month was it?— In June*. 

Was the soldier who was first attacked with Plague, in 
barracks or quartered in the town?— I shall be under the 
necessity of consulting my medical register; but I have no 
doubt he was in barracks. 

Could any communication, personal communication, be 
traced between the soldier first infected and any other sol • 
diers who were afterwards infected ? — I do not know that 
any had been attempted to be traced ; for when soldiers live 

* On the 28th of June. 



BEFORE THE SELECT COMMITTEE. 



21 



in the gregarious manner they do, it would be in vain to 
make the inquiry.* 

Were the soldiers kept within their barracks, previous to 
the appearance of the Plague among them, and their com- 
munication with the inhabitants prevented ?— In some of the 
barracks it was prevented, in some not; and it is material, 
in order to prove the contagious property of the disease, that 
in those barracks where a strict quarantine system appeared 
to be kept up, the Plague was excluded, though they were 
in an unhealthy part of the town ; whereas in other places 
that were more elevated and airy, but where there seemed 
not to be the same precautions observed, the disease was 
brought in. 

Then the soldier first infected was in one of those bar- 
racks that had a more free communication with the town ; 
had you the charge of the sick in the barrack in which the 
first case occurred ? —I had partly the charge of them in this 
barrack, but not in the first case. 

When did your charge of the Plague patients commence? 
— It was relative to that point I wished to consult my regis- 
ter ; but as far as I can state with confidence, I was not 
employed officially to prescribe till De Rolle's regiment was 

* On referring to the Medical Reports of Malta, published during the 
Plague, I have ascertained that those who slept in the same room with the 
soldier 6ist infected, were the first victims to the complaint in the army. 



22 



THE AUTHOR'S EVIDENCE 



infected. I think I was called in to see some other cases 
but I had them not under my charge. 

Were you yourself, in attending the sick, (those who were 
ill of the Plague,) in contact with them ?— Personally close 
to them, as nearly as it was necessary for me to approach 
them. 

Had you the Plague?— I believe not; though I have 
some doubt respecting that. 

Who were the persons employed under you in the care of 
the sick ? — Orderlies and such like. 

Did any of them catch the Plague ? — Not one. 

Were they necessarily in contact with the individuals who 
had the Plague, and with their clothes and bedding?— 
Necessarily. 

Were any precautions taken with the view of preventing 
hem from catching the Plague, in the discharge of their 
duties ? — Oiled silk dresses were enjoined by command to be 
worn by every person in attendance about the sick. 

Was it complied with ? — It was I believe, in point of fact ; 
they were also enjoined a prompt ablution after touching the 
infected, they were obliged to wash their hands ; in short 
every means were adopted to prevent their catching the in- 
fection, with the addition of ablutions. 

Was one of the precautions rubbing the body with oil ?— 
It was ; but there are the best reasons for supposing that it 
had no share in preventing the infection. 



BEFORE THE SELECT COMMITTEE. 



23 



What reason ?— It had been employed with all the atten- 
tion possible in the garrison ; but yet the disease made its 
way. It had been employed by tho6e who attended in car- 
rying out the dead, and who I believe almost all perished ; 
there were very few instances of such persons who did not 
perish. 

When you describe the Plague as contagious, do you 
mean that it is communicated by the breath ? — 1 am not pre- 
pared to say whether it may not, by closely inspiring the 
breath of an infected person ; but this in my judgment is a 
kind of contact. My opinion is, that it is principally com- 
municable by the touch, but I think it can be communicated 
in the former way also ; few would be hardy enough to try 
the experiment. 

If it had been communicated by the breath, how can 
wearing oil-skin dresses or ablution prevent the breath of the 
infected persons getting into the mouth or nostrils from the 
infected?— We know, that at a certain distance in other 
diseases, the contagion from fomites may be so diluted by 
the atmosphere as to become innoxious. 

Was the progress of the Plague among the troops rapid ? 
— It was not rapid. 

Not so rapid as among the inhabitants ? — Not at all ; in all 
not above 20 [ believe died up to the middle of October. 



24 



THE AUTHOR'S EVIDENCE 



The progress of the disease 1 mean ?— In some it was 
rapid, and in some it was not : there was every variety. 

What was the per centage of those in garrison attacked ? 
— I am not prepared to say. 

Was it a greater or less proport ; on than the inhabitants? 
— A less proportion. 

The precautions applied to the troops were more rigid 
than those that could be applied to the population ? — Cer- 
tainly. I was going on to state some circumstances as to the 
degrees of precautions used in each of the military barracks. 
The Sicilian regiment, though situated in a very infected 
part of the island, a place called Floriana, escaped by the 
promptness and vigilance of Col. Kivarolla. De Rolle's 
regiment, which was on the healthiest spot, was invaded by 
the disease, and evidently in my opinion in consequence of 
their barrier admitting a contact with persons on the outside. 
It was a barrier at which you could shake hands with any 
body on the outside. In the 14th regiment, which was 
near the most unhealthy part of the town, there was but one 
person suspected, and his disease was immediately arrested ; 
the public prison * and public general hospital escaped. The 
convents in Valetta escaped, with the exception, I believe* 
of one ; and the introduction of the disease to that one was 

* It appears hy the Public Medical Report, that this place was at length 
infecled. 



BEFORE THE SELECT COMMITTEE. 



25 



accounted for. The prison and these public institutions 
escaped, I conceive, very much by the voluntary attention 
paid by their inhabitants to a strict system of quarantine. 

Did the Plague cease in the military hospitals before it 
ceased in the town ? — I am not prepared to answer that 
question. 

Were the soldiers in barracks prevented from holding 
communication with the town, after the Plague had ceased in 
the barracks ?— I believe so ; that would greatly depend 
upon the commanding officer. 

I ask you, whether in point of fact, they were? — Through- 
out the whole they were interdicted as far as possible ; the 
commanders of regiments issued orders to prohibit inter- 
course, but they were not strictly obeyed. 

Did the Plague find its way into any of the barracks or 
regiments, where these orders were not strictly observed? 
It got into De Rolle's regiment particularly. 

You have stated, that these three cases of Salvatore Bprg, 
Agius and Gozo, were cases you received from information ; 
now I observe in many cases that came under your own 
knowledge, it did not communicate to persons ; do you not 
consider that the natural time of the decrease of the Plague 
is the fall of the year? — It is my own opinion, that it would 
cease if the temperature was low ; 1 think that the Plague 
is incompatible with a certain temperature, high or low. 

E* 



26 



THE AUTHOR'S EVIDENCE 



Then it is not the particular period of the year ?— No. 

You stated it to appear prior to August, but the restriction 
was not till the 2d August ?— Not in its full rigour, but an 
improved system was acted upon in July. 

The ship Nicolo returned to Alexandria with her whole 
cargo, did she not ? — If I may except those bales which 
were rumoured to be missing. 

She was not allowed to land her cargo ? — No. 

Who navigated her back? — Probably the remaining part 
of the crew. 

Was she not navigated back by Maltese ? — She might. 

Do you know whether they took the Plague ? — They 
arrived in safety. 

Did they who assisted in landing the cargo ? — I believe so. 

Are there any eruptions in the skin, in the Plague? — If 
we can call eruptions what are termed blains and carbuncles. 

Do you consider a buboe or carbuncle to be an eruption ; 
-—I should think so ; it is freely applicable to the term ; 
its etymology is from erumpo, which is to break forth. 

Does not eruption mean a cluster of pimples ? — In common 
acceptation it may. 

Do you think the Plague comes under the description of 
Exanthemata?— I think it does; I believe that Dr. Cullen 
has given the best account of the disease. 

You have stated, that the contagion in Plague is what is 



BEFORE THE SELECT COMMITTEE. 27 

called sui generis, do you consider it different from contagion 
in the small-pox 1— Different from any other known con- 
tagion. 

Have you ever heard of the Plague in England ?— I have 
read of it. 

In what year ] — The last was in 1665. 

Have you ever heard of Plague since? — Never, as 
imported into England. 

Do you consider the Plague can be propagated from goods 
as well as persons? — I think so. 

Have you any reason for thinking why the Plague has 
not been introduced from goods in the quarantine establish- 
ments ? — In the first place, quarantine restrictions since 1709 
have been a great deal more rigid; indeed they did not 
exist in England at all, previous to that period. I conceive 
that the intensity of the contagion may have been greatly 
blunted by the length of the voyage, and the length of time 
that passes after the shipment of goods, besides we know, 
that other countries have a good system of quarantine, 
which is in favour of the Plague not being imported here. 

Do you consider the Plague of 1665 to be the true Levant 
Plague? — From the description I have read of it I am 
inclined to think so. 

Do you consider the reason why the Plague has not 
been introduced in England, has been more from the length 



28 



THE AUTHOR'S EVIDENCE 



of time in the voyage, than the quarantine establishment ? 
— I mean both conjunctively, viz. the time and the means 
used to free goods from contagion, and to expurgate 
infection. 

How do you account for the expurgators never having 
taken the Plague? — 1 cannot account for that, but by col- 
lateral considerations. 

What are those ? — First. That we have observed, in other 
countries the disease has not taken place for a long series of 
years, not for an hundred and thirty years in Malta. Se- 
condly. We do not know what the circumstances are that 
constitute aptitude in the receiver, sufficiently, to know 
why the Plague has not been received into the lazarettos 
since 1665. But Thirdly, it does not follow because it has 
not been received into the lazarettos since 1665, that it may 
not by some fortuitous concurrence of circumstances occur 
again here. 

Are you acquainted with the opinion of the ancients, 
respecting the Plague?— I am. It has been stated, that the 
ancients were not acquainted with contagion, but 1 can 
adduce instances from the medical writers and the poets to 
the contrary ; I can produce instances from both the Greek 
and Roman writers and poets. 

Does Hippocrates mention it 1 — He does not. He had 
not the experience to determine the point; but with respect 



BEFORE THE SELECT COMMITTEE. 



29 



to the authorities that do speak of contagion, I shall beg 
to refer to the following, viz. * 

(* Here I produced several passages from Aristotle, Aretaeus, Galen, 
Tacitus, Livy, and Virgil, which have already been cited.) 



Veneris, 26° die Martij, 1819- 
SIR JOHN JACKSON, BARONET, 
In the Chair. 

Sir Arthur Brooke Faulkner, again called in ; and 
Examined. 

I THINK you wish to add to your answer respecting the 
air of Malta? — I was observing that a high wind, from what- 
ever quarter it blew, was always accompanied with some in- 
crease of the number of infected. 

Can you give an undoubted proof of the contagion of 
Plague, from any fact that came under your own eye or per- 
sonal knowledge? — At the military barracks I think, cer- 
tainly. 



30 



THE AUTHOR'S EVIDENCE 



What was it? — The attacks being consecutive,* as from 
contact, instead of being simultaneous ; it was impossible to 
trace immediate contact with an infected person in barracks, 
where soldiers were so much together, and lived so gre- 
gariously. 

If the air was the general cause of Plague, must not that 
have operated as the cause, in the instance to which you 
have alluded? — Certainly not ; if the air had operated as the 
cause, the disease would not have extended consecutively, 
as I have shewn to be the case, but would have been pro- 
duced through the corps simultaneously ; the same would 
have happened through the population of the island, espe- 
cially as there were several parts of the island, from local cir- 
cumstances affecting the air, more exposed to contamination 
than Valetta. 

Is Valetta a lower part of the island than the other parts ? 
— I am not quite sure respecting that ; but it is universally 
allowed to be one of the most healthy parts of the island, the 
most free from marsh fevers; and as an instance, I may 
mention, that in 1801, when marsh fevers were very fatal 
and numerous, Valetta entirely escaped. 

Was there any fever except on board the San !N icolo, at 
the time? — 1 cannot speak with positive certainty, but J 
think it not unlikely, as vessels from Alexandria, an infected 

* Vide note, p, 21, apj». 



BEFORE THE SELECT COMMITTEE. 



31 



port at that time, were not excluded from entering the har- 
bour contiguous to Valetta. 

Whereabouts was Salvatore Borg's house?— In Strada 
St. Paulo. 

Is that far from Valetta?— It is in Valetta. 

Is Valetta the fort?— It is a considerable and well forti- 
fied city, the largest in the island; it is the last spot where 
one would look for marsh fevers or diseases of any kind, 
being perflated with pure sea air in every direction, and the 
soil being perfectly dry. 

Would not the numerous instances you have alluded to, 
of persons having escaped the Plague who had come from 
the bosom of families afflicted with it, be an inducement, if 
not a proof for deeming Plague not contagious ? — Neither 
an inducement nor a proof; for we see in other diseases al- 
lowed to be contagious, the small-pox for example, that 
many such escapes have taken place. 

Have you any better proof for deeming Plague contagious, 
than the preceding observation on my question for deeming 
it not contagious ? — I think that when the whole evidence I 
have given, respecting the propagation of the Plague in a direct 
line, be well weighed and considered, and when we see that 
any other supposable cause than contagion is inadequate to 
account for such extension of the disease in a direct line, the 
proof is made out as far as presumptive evidence can 
well render it. 



32 



THE AUTHOR'S EVIDENCE 



Do you know how many died of the Plague in the har- 
bour?— None in the harbour; two I believe died on their 
passage to Malta from Alexandria, and two died in the 
lazaretto after the infected crew were sent on shore. 

You know the ship San Nicolo was sent back to Alex- 
andria, without unloading, from Malta?- It was notori- 
ously stated. 

And do you know that the goods were landed at Alexan- 
dria, and none of the persons took the Plague who went 
with her? — I believe none of the persons who navigated her 
back took the Plague, but arrived in perfect health ; farther 
I know not ; I know nothing of her unloading ; I have 
said, there was a report that some bales of goods were 
missed, but I only speak from public conversation. 

Is it not more likely that the persons who went with her 
to Alexandria should have received the Plague, than that a 
bale of linen carried into Malta from her should have pro- 
duced the Piague ? — The ship had undergone a very con- 
siderable quarantine; and 1 heard that means were taken to 
prevent her from infecting those engaged in her navigation. 

Do you suppose her goods were unladen ? — I believe not ; 
in every other respect as far as circumstances would admit, 
without unlading, I have heard she was expurgated from in- 
fection above decks, but I am not certain of this. 

Do you believe it would be possible to ventilate the goods 
without unlading them?—! think it would be impossible. 



BEFORE THE SELECT COMMITTER. 



35 



What number of military were at Malta in 1813?— To 
the best of my recollection, about four thousand. 

What was the greatest number of military afflicted with 
the Plague, at the same time ?— I am not prepared to an- 
swer, as the returns of the whole army were never in my 
possession ; but I can speak as to those under my own care ; 
I have the return of them in my pocket : 4th July , the first 
case was placed officially under my care ; the second was 
the 8th July. 

What is the greatest number at any one time ? — I beg to 
read the return ; the third case was the 20th July, the fourth 
case the 21st July, the fifth case the 21 st July, the sixth case 
the 23d July, seventh 25th July, the eighth case is the 28th 
July, the ninth case is the 2d August ; 1 believe that this is 
the last officially under my care. 

The sick of all the persons were under your care?— ^Not 
of all the forces ; some of them were attended by their own 
regimental surgeons within their own barracks; those sick 
only properly belonged to me officially, that were sent into 
a general hospital, although I did attend also in the regi- 
mental hospitals ; we were at one time so ill * off for a 
general pest hospital, that medical staff officers were under 

* This inconvenience was speedily obviated by the appropriation of part 
of a convent to this purpose. 

F* 



34 



THE AUTHOR'S EVIDENCE 



the necessity of attending Plague cases at the barracks 
under canvass. 

Have you any recollection of the number of soldiers ait©- 
gethei taken ill of the Plague?— In all, our army had not 
hitherto lost above twenty ; up to the date before-mentioned. 

What date ?— Up to October. 

Were any taken ill after that ? — I believe some solitary 
instances occurred after that. We lost very few in all. 

Was any medicine administered which was successful in 
these cases? — Some articles seemed to be very successful, 
but there could be no dependence placed upon any. 

Would you like to mention anyt — Those which I found 
most beneficial were the cold affusion and turpentine * ; to 
which of the two it is difficult to ascribe the good effects. 

Did you use mercury? — I did. 

Blood letting ; — Yes, by leaches, topical blood letting. 
Camphor I also used, and several other medicines. Calo- 
mel was reported to me as having done some good under 
the care of the garrison battalion surgeon, but I never found 
it myself of any use. 

* On farther reflection, I conceive it very doubtful that the recovery of 
the two cases iu which turpentine was exhibited, could be ascribed to that 
remedy, as they had continued to brave the disease some days previous to 

its administration, 



BEFORE THE SELECT COMMITTEE. 



35 



Of those infected with the Plague, how many do you 
suppose recovered among the soldiers 1 — I can only speak 
as to De Rolle's Regiment; I think nearly one half. 

"Was there any Plague at Sasai? — None, nor at some 
other casals in the island. 

To what do you attribute that? — To infected persons 
not having made their escape to those casals. * 

Was there an order from the commader in chief not to feel 
the pulses of the Plague patients, under a fine of 80 days 
quarantine ? — There was. I find now on referring to my 
notes, that I have made a mistake ; the medical men were 
interdicted from feeling pulses, only under a penalty of 
quarantine for a considerable number of days ; the mulct 
for feeling pulses (even through a tobacco leaf) being not 
less than 15 or 20 days. 

Did you go among or near many persons afflicted with the 
Plague, or did you keep personally from them, except among 
your own soldiers ?— I volunteered my services to examine the 
patients in the lazaretto, some of whom I saw and examined e 

Do you recollect any who were ill in the lazarettos ? — I 
rather think I was prevented from seeing the living cases of 
Plague within their wards f and that I examined more par- 
ticularly the dead. 

* Or to more vigorous restrictive measares. 
t This is not rightly expressed ; I only intended to say, that 1 did not 



36 



THE AUTHOR'S EVIDENCE 



Do you consider dead cases capable of producing 
Plague ?— From the general opinion which is abroad on this 
point, I should consider they are not so liable, if liable at all. 

Has the quarantine in Malta been regularly attended to, 
prior to the breaking out of the Plague ?— I have had no op- 
portunities of judging of that; my attention to quarantine 
laws was not particularly arrested, till I saw danger in 
our neighbourhood. 

Is it not likely to suppose that cases of Plague have fre- 
quently arrived in Malta, prior to the breaking out of the 
Plague ? — I understood that it had frequently been known 
in the lazaretto, but was stopped by prompt precaution. I 
yesterday produced the title-page of a book, in which there 
was an engraving of a monument to the memory of a grand 
master in 1743, who had arrested the Plague. 

Did you remain at Malta after 1813?— I think 1 left 
Malta in April or May 1814. 

Was there a Plague in May 1814, at Malta? — I never 
heard it recurred in that year. 

What was done with the clothes and bedding of the per- 
sons who died of the Plague?— I understood, gene- 
rally destroyed ; though in some instances, not until long- 
after their being infected. 

enter the wards to see the living cases ; which I ought to have added, I 
*a\v sufficiently will from the outside. 



BEFORE THE SELECT COMMITTEE, 



37 



Upon the whole, do you consider the Plague to be a 
disease propagated by contagion, like the small-pox and 
other eruptive diseases?— I do. 

Do you believe it may be so propagated, independent of 
any influence of the atmosphere ?— I believe it may.* 

Do you consider insulation by the means of quarantine, 
the most effectual method of preserving against the Plague? 
— By far the most effectual. 

Do you know of any cause of communication of Plague, 
besides contagion ? — None that will explain its production 
and dissemination, except a contagion sui generis. 

Explain your meaning of sui generis ? — I believe it signifies 
whatever is peculiar to the thing spoken of, consequently 
the contagion of Plague is quite peculiar in producing the 
Plague. Take other examples ; the contagion of the small- 
pox is peculiar in producing small-pox only ; the contagion 
of the measles is peculiar in producing measles only ; and so 
in like manner the contagion of the Plague is peculiar to 
itself, or what is termed specific. 

By peculiar, do you mean that the contagion of the 
Plague will produce Plague, and the contagion of the small- 
pox, small-pox?— I mean that only. 

Then you do not allude to the mode of producing the 

* Mv sentiments hare been given more distinollj on this head in eliap. v. 



38 



THE AUTHOBfl EVIDENCE 



effect? — We know nothing of the modus operandi of the 
contagion, it. ts quite inscrutible. 

Do you wish to state something as to the arrangement for 
the guards? - I should bare mentioned in my examination 

on this head, that Some part of the police guards wore en- 

rolled m tin month of July, by the gentleman placed at the 
h<: id of the police. 

Have you ever heard of the Plague in England?*—] have. 

Mention the year ? — I have read of several having visited 
England, but my recollection respecting them is not distinct; 
\ recollect most of that Plague which occurred in the year 
1695. 

Do you consider Dr. Sydenham's account of the Plague 
as the best? I think Dr. Sydenham's account, did not result 

from any very patient or philosophical investigation of 

the disease. 

Does Dr. Sydenham consider it the real Levant f'lagm I 
I think not,; but it is so long Since S read the work, thai 

I cannot charge my memory with any of his observations. 
Do you consider it yourself, as the real Hague of the 

Levant % — 1 do, decidedly. 

Have you ever beard of Plague since that period ? — I am 
not prepared to answer tha t, question ; whether it has visited 
England since cu not, ! should apprehend* could only be 

answered by thoseengaged aboul the health office. 



BEFORE THE SELECT COMMITTEE. 



39 



If the expurgators of goods at the quarantine establishment 
have never received Plague from opening the bales from the 
Levant, even those which come with foul bills of health, 
should you not from thence conclude, that there was no 
matter of infection contained in the bales?— IS o; the cau- 
tion enjoined in the operation of expurgation may be suffi- 
ciently great to prevent the reception of contagion of Plague, 
even though it existed; the intensity of the contagion may 
be so blunted by length of time, and by care, as not to be 
calculated to excite the disease readily. 

Has it not astonished you, that for a period of 154 years, 
there should have been no occurrence of Plague in England ? 
— I cannot say it astonishes me more with respect to Eng- 
land than other places. I find it has paid visits at the 
distance of long intervals of time to other countries as well 
as England; and we do not know enough of what constitutes 
aptitudes in persons to receive the contagion, in order to 
know under what circumstances the disease must necessarily 
be produced. 

Do you consider the quarantine establishments in England to 
have been one of the causes of preventing Plague from being 
introduced? — I should think the quarantine establishment 
taken in all its bearings, abroad and at home, has had a 
great share in preventing the introduction of the disease 
Do you suppose the corn is capable of producing in fee- 



40 THE AUTHOR'S EVIDENCE 

tion, and therefore ought to be the subject of the quarantine 
laws? — On that point I am not able to speak; I do not be- 
lieve it is considered an article of high susceptibility. 

To what articles should you attribute the greatest proba- 
bility of Plague infection? — I cannot be certain, but I 
should rather think woollen clothes and cotton ; upon this 
part of the subject I would rather not answer ; I am very 
doubtful with respect to the susceptibility of different articles. 

Were the arrangements made at Malta, respecting the 
Plague in 1813, very expensive to Government, during the 
Plague?— I should think they must have been a very great 
expense ; but I only speak from surmise, concluding from 
what I saw. 



REPORT. 



THE SELECT COMMITTEE appointed to consider the 
validity of the doctrine of Contagion in the Plague ; and 
to report their observations thereupon, together with the 
Minutes of the Evidence taken before them, to The 
House ; — HAVE considered the matters to them re- 
ferred, and have agreed upon the following REPORT. 

YOUR Committee being appointed to consider the 
validity of the. received Doctrines concerning the nature of 
Contagious and Infectious diseases, as distinguished from 
other Epidemics, have proceeded to examine a number of 
Medical Gentlemen, whose practical experience or general 
knowledge of the subject appeared to Your Committee 
most likely to furnish the means of acquiring the most 
satisfactory information. They have also had the evidence 
of a number of persons whose residence in infected coun- 
tries, or whose commercial or official employments, enabled 
them to communicate information as to facts, and on the 

G * 



42 REPORT FROM THE SELECT COMMITTEE ON THE 



principle and efficacy of the laws of Quarantine ; all the 
opinions of the Medical men whom Your Committee have 
examined, with the exception of two, are in favour of the 
received doctrine, that the Plague is a disease communi- 
cable by contact only, and different in that respect from 
Epidemic fever; nor do Your Committee see any thing in 
the rest of the Evidence they have collected, which would 
induce them to dissent from that opinion. It appears from 
some of the Evidence, that the extension and virulence of 
the disorder is considerably modified by atmospheric in- 
fluence ; and a doubt has prevailed, whether under any cir- 
cumstance, the disease could be received and propagated in 
the climate of Britain. No fact whatever has been stated 
to show, that any instance of the disorder has occurred, or 
that it has ever been known to have been brought into the 
Lazarettos for many years : But Your Committee do not 
think themselves warranted to infer from thence, that the 
disease cannot exist in England ; because, in the first place, 
a disease resembling, in most respects, the Plague, is well 
known to have prevailed here in many periods of our his- 
tory, particularly in 1665-6; and further, it appears that in 
many places, and in climates of various nature, the Plague 
has prevailed after intervals of very considerable duration. 

Your Committee would also observe, down to the year 
1800, Regulations were adopted, which must have had the 



i 



DOCTRINE OF CONTAGION IN THE PLAGUE. 43 

effect of preventing- goods infected with the Plague from 
being shipped directly for Britain ; and they abstain from 
giving any opinion on the nature and application of the 
Quarantine regulations, as not falling within the scope of in- 
quiry to which they have been directed ; but they see no 
reason to question the validity of the principles on which 
such regulations appear to have been adopted. 



14 June, 18 19. 



- 




